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	<title>Polite Dissent</title>
	
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	<description>a blog of medicine, comics, television, science and other fun stuff</description>
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		<title>Fringe — Episode 8 (Season 2): “August”</title>
		<link>http://www.politedissent.com/archives/4045</link>
		<comments>http://www.politedissent.com/archives/4045#comments</comments>
		<pubDate>Fri, 20 Nov 2009 05:44:53 +0000</pubDate>
		<dc:creator>Scott</dc:creator>
				<category><![CDATA[TV]]></category>

		<guid isPermaLink="false">http://www.politedissent.com/?p=4045</guid>
		<description><![CDATA[A fairly light episode of Fringe, but an enjoyable one

The Plot:The Observer is patiently standing in front of a museum in Boston, taking notes, and spying on brunettes.  After a few minutes, he finds the one he wants, grabs her, throws her in the back of a stolen car and drives off.   [...]]]></description>
			<content:encoded><![CDATA[<p><em>A fairly light episode of Fringe, but an enjoyable one</em></p>
<p><center><img src="http://politedissent.com/images/hline.gif" alt="Fringe #208" vspace="5"/></center></p>
<p><span style="font-weight: bold; color: darkred;">The Plot:</span>The Observer is patiently standing in front of a museum in Boston, taking notes, and spying on brunettes.  After a few minutes, he finds the one he wants, grabs her, throws her in the back of a stolen car and drives off.   Arriving at an out of town motel, he gags her and ties her to a chair, and then leaves.</p>
<p>With the Observer involved, the Fringe team is called in.  The kidnap victim is identified as Christine Hollis, and seems to be an entirely normal young woman.  They review the surveillance camera footage and realize that this is a different Observer than the one they first met.  It turns out that the Observer accidentally left his notebook behind, so it’s turned over to the team; however, they are unable to decipher the code/language in the book.  Astrid identifies over 1200 different symbols, without any repeats.  Looking online, she discovers that one of the researchers at Massive Dynamics is also interested in the code.  He has not been able to solve it either, but he has documented evidence of Observers at important historical events including the <a href="http://www.americaslibrary.gov/cgi-bin/page.cgi/jb/revolut/boston_1">Boston Massacre</a>, the <a href="http://www.freerepublic.com/focus/fr/1720376/posts">beheading of Marie Antoinette</a>, and the shooting of <a href="http://www.eyewitnesstohistory.com/duke.htm">Archduke Ferdinand</a>.  Peter finds a drop of what appears to be blood in the Observer&#8217;s journal.  Walter notes its orange cast and wonders if the Observer might not have hemophilia.</p>
<p><img src="http://www.politedissent.com/images/nov09/penalty.jpg" alt="Shame on Fox, Fringe, and Ford" align="right" hspace="10"/>At a restaurant across town, a group of three Observers are meeting to discuss the actions of the rogue Observer, whom they call &#8220;August&#8221;.  They mention a plane flight and imply that Christine is supposed to be dead, so they send an assassin after her.</p>
<p>August returns to the hotel room, unties Christine, and shows her the television news, which reports that the flight she had booked to Rome crashed en route with no survivors.</p>
<p>The labs tests come back and the drop in the journal wasn&#8217;t blood, but hot pepper sauce &#8212; and sauce from a particular hot pepper:  the King Cobra Chili.  Astrid is able to find the address of the individual who imported some last year, so Olivia and Peter head over to check it out.  As luck would have it, the Observers&#8217; assassin is there at the same time.  There are some fisticuffs and Peter sustains a small wound, but the assassin escapes.</p>
<p>August meets with the other Observers.  They tell him that Christine must be killed to set things right.  This is not what he wants to hear.  He manages to set up a meeting with Walter, asking for his help.  All Walter can tell him is that he must somehow make Christine important to the Observers, so they won&#8217;t kill her.</p>
<p>August returns to the hotel room and unties Christine.  He tells her that she must do exactly as he says.  A short time later, the assassin appears at the hotel and in the ensuing battle, August is shot and critically wounded.  Olivia and Peter arrive, and August gives his gun to Peter.  Together, Peter and Olivia are able to kill the assassin.  They find Christine and return her home.</p>
<p>The first Observer picks up August and drives him away from the hotel.  As August lies dying in the back, he tells the other Observer that he had developed &#8220;feelings&#8221; for Christine, even loved her &#8212; and that is why he saved her.  The first Observer tells August that she is safe now because she is responsible for the death of an Observer, and that makes her important.  </p>
<p><center><img src="http://politedissent.com/images/hline.gif" alt="Fringe #208" vspace="5"/></center> <em><br />
Overall, the science &#8212; what little there was of it &#8212; was passable this episode, so I just have a few nit-picks an observations:</em></p>
<p><span style="font-weight: bold; color: darkred;">1.  Hot, Hot, Hot</span><br />
The <a href="http://en.wikipedia.org/wiki/Naga_Jolokia_pepper">King Cobra Chile</a> is the hottest chile known to man, scoring 850,000 to 1,000,000 <a href="http://en.wikipedia.org/wiki/Scoville_scale">Scoville units</a>.  It is also known as the &#8220;ghost chile&#8221;, which should be familiar to you if you watch <strong><a href="http://www.travelchannel.com/TV_Shows/Man_v_Food">Man v. Food</a></strong>. </p>
<p><span style="font-weight: bold; color: darkred;">2.  15% Tip</span><br />
Why would it be a surprise that the tip about August was called in from the same hotel?  Would it really be a shock that one of the other guests, or an employee, saw him and phoned it in?</p>
<p><span style="font-weight: bold; color: darkred;">3.  Color of Love</span><br />
This is the first I&#8217;ve ever heard of hemophiliacs having orange blood, and I don&#8217;t buy it.  <a href="http://www.nhlbi.nih.gov/health/dci/Diseases/hemophilia/hemophilia_what.html">Hemophilia</a> affects the clotting of the blood, not the hemoglobin (which is what gives blood its red color), so why would the blood be a different color?</p>
<p><span style="font-weight: bold; color: darkred;">4.  You Go That Way, I&#8217;ll Go This Way</span><br />
I would not want to be Olivia&#8217;s insurance agent, and I hate for her to be my backup.  Tonight she:  1) was easily distracted by the assassin, 2) nearly shot Peter, and 3) only avoided being shot by the assassin due to dumb luck and Peter.</p>
<p><center><img src="http://politedissent.com/images/hline.gif" alt="Fringe #208" vspace="5"/></center></p>
<p><em>A much better episode this week.  The show does much better when they stick with the Pattern.  There is a one-minute improvement on the Doomsday Clock.</em></p>
<p><center><img src="http://www.politedissent.com/images/doomsday6.jpg" alt="Fringe Doomdsday Clock" width="200" height="200" title="At the tone, the time will be 11:56" /></center></p>
<div style="margin-left: 180px; text-align: left;">
<img src="http://www.politedissent.com/images/check.gif" alt="Fringe"/><font color="green">This week&#8217;s Fringe cipher was: BLIGHT.</font><br />
<img src="http://www.politedissent.com/images/check.gif" alt="Fringe"/><font color="green">A list of all previous Fringe reviews is available <a href="http://www.politedissent.com/fringe.html">here</a>.</font><br />
<img src="http://www.politedissent.com/images/check.gif" alt="Fringe"/><font color="green">Karl has <a href="http://blog.cordialdeconstruction.com/2009/11/19/deconstruction-review-of-fringe-episode-8-season-2-august/">much more to say</a>.</font>
</div>
<p><center></p>
<div class="stag"><strong>Tags:</strong> <a href="http://politedissent.com/index.php?cat=8" rel="tag">television</a> <a href=http://politedissent.com/index.php?s=fringe&#038;submit=search" rel="tag">fringe</a> <a href="http://politedissent.com/index.php?s=observer&#038;submit=search" rel="tag">observer</a> <a href="http://politedissent.com/index.php?s=hemophilia&#038;submit=search" rel="tag">hemophilia</a> <a href="http://politedissent.com/index.php?s=scoville&#038;submit=search" rel="tag">scoville</a></div>
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		<title>Tuesday PSA:  Binky Presents ‘Pioneers of 1976!’</title>
		<link>http://www.politedissent.com/archives/4027</link>
		<comments>http://www.politedissent.com/archives/4027#comments</comments>
		<pubDate>Wed, 18 Nov 2009 05:27:17 +0000</pubDate>
		<dc:creator>Scott</dc:creator>
				<category><![CDATA[Comics]]></category>

		<guid isPermaLink="false">http://www.politedissent.com/?p=4027</guid>
		<description><![CDATA[In this public service ad, Binky&#8217;s younger Allergy and his friends ponder the future &#8212; the far, far distant future &#8212; of 1976.
Click on the image for the full ad

Let&#8217;s see how Allergy and his friends did in their predictions:
Moon crater tours.  Nope, not there yet.
Video conferencing.  Good call, though not quite as [...]]]></description>
			<content:encoded><![CDATA[<p><a href="http://www.politedissent.com/images/nov09/pioneer.html" onclick="window.open('http://www.politedissent.com/images/nov09/pioneer.html', 'popup', 'width=630, height=850,  scrollbars=yes,  resizable=yes, toolbar=no, directories=no, location=no, menubar=no, status=no, left=0, top=0'); return false"><img src="http://politedissent.com/images/nov09/pioneer.jpg" alt="Binky Presents 'Pioneers of 1976!' Click for the full page." title="Binky Presents 'Pioneers of 1976!'  Click for the full page." align="right" hspace="10" width="202" height="200"/></a><a href="http://www.politedissent.com/?s=buzzy"></a>In this public service ad, Binky&#8217;s younger Allergy and his friends ponder the future &#8212; the far, far distant future &#8212; of 1976.</p>
<p><center><big><em>Click on the image for the full ad</em></big></center></p>
<div style="border: 1px solid darkgreen; padding: 2px 5px; margin: 15px 10px; width: 420px; font-size: 85%; ">
Let&#8217;s see how Allergy and his friends did in their predictions:<br />
<img src="http://www.politedissent.com/images/x.gif" alt="wrong!" hspace="8"/>Moon crater tours.  <em>Nope, not there yet.</em><br />
<img src="http://www.politedissent.com/images/check.gif" alt="right!" hspace="5"/>Video conferencing.  <em>Good call, though not quite as predicted.</em><br />
<img src="http://www.politedissent.com/images/x.gif" alt="wrong!" hspace="8"/>Large bulky electronic machines. <em> Passed it by and left it in the dust.</em>
</div>
<p>This PSA is found in DC comics from June 1956.  The writer, as always, was Jack Schiff.  Art by Win Mortimer.</p>
<p><center><img src="http://politedissent.com/images/cad.jpg" alt="More PSAs" hspace="5"/><a href="http://www.politedissent.com/index.php?s=psa&#038;submit=search">More PSAs</a></p>
<div class="stag"><strong>Tags:</strong> <a href="http://politedissent.com/index.php?cat=2" rel="tag">comics</a> <a href="http://www.politedissent.com/index.php?s=psa&#038;submit=search" rel="tag">psa</a> <a href="http://www.politedissent.com/index.php?s=binky&#038;submit=search" rel="tag">binky</a> <a href="http://www.politedissent.com/index.php?s=allergy&#038;submit=search" rel="tag">allergy</a> <a href="http://www.politedissent.com/index.php?s=schiff&#038;submit=search" rel="tag">jack schiff</a> <a href="http://www.politedissent.com/index.php?s=mortimer&#038;submit=search" rel="tag">win mortimer</a></div>
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		<title>House — Episode 7 (Season 6): “Teamwork”</title>
		<link>http://www.politedissent.com/archives/4019</link>
		<comments>http://www.politedissent.com/archives/4019#comments</comments>
		<pubDate>Tue, 17 Nov 2009 06:37:26 +0000</pubDate>
		<dc:creator>Scott</dc:creator>
				<category><![CDATA[Medicine]]></category>
		<category><![CDATA[TV]]></category>

		<guid isPermaLink="false">http://www.politedissent.com/?p=4019</guid>
		<description><![CDATA[The mystery was fairly bland in this week&#8217;s episode of House, but the medicine was much better overall.  Good bye Cameron.  Don&#8217;t let the door hit you on the way out.

Hank, a successful porn star is admitted to Princeton Plainsboro Teaching Hospital after developing a severe headache and photophobia (sensitivity to light) while [...]]]></description>
			<content:encoded><![CDATA[<p><em>The mystery was fairly bland in this week&#8217;s episode of House, but the medicine was much better overall.  Good bye Cameron.  Don&#8217;t let the door hit you on the way out.</em></p>
<p align="center"><img src="http://politedissent.com/images/spoiler.gif" alt="Spoiler Alert!!" /></p>
<p>Hank, a successful porn star is admitted to Princeton Plainsboro Teaching Hospital after developing a <strong>severe headache</strong> and <strong><a href="http://www.allaboutvision.com/conditions/lightsensitive.htm">photophobia</a></strong> (sensitivity to light) while on set.  House starts off by ordering a series of tests: an <a href="http://labtestsonline.org/understanding/conditions/std.html">STD panel</a> (to look for sexually transmitted diseases), a toxin screen (to look for common toxins),  <a href="http://labtestsonline.org/understanding/analytes/crp/test.html">C-Reactive Protein</a> (&#8221;CRP&#8221;, a measure of inflammation), <a href="http://labtestsonline.org/understanding/analytes/ana/test.html">ANA</a> (antinuclear antibodies, to look for autoimmune diseases) and a <a href="http://www.webmd.com/brain/lumbar-puncture">lumbar puncture</a> (to look for <a href="http://www.pdrhealth.com/disease/disease-mono.aspx?contentFileName=BHG01ID01.xml&#038;contentName=Viral+Encephalitis&#038;contentId=159">viral encephalitis</a>).  While the patient is having his <a href="http://www.youtube.com/watch?v=NeGteg74mjw">spinal tap</a> performed, he develops severe muscle spam and pain (<a href="http://en.wikipedia.org/wiki/Tetany_(medical_sign)"><strong>tetany</strong></a>) in his arms.  Foreman orders <a href="http://www.drugs.com/mtm/meperidine.html">meperidine</a> (Demerol, a strong pain medication).</p>
<p>About this time, House starts hitting up Taub and Thirteen for ideas, trying to lure them back on the team.  Taub suggests that Hank must have a brain problem, such as a <strong>tumor</strong> or <strong>seizure</strong>.  Foreman believes that Hank suffers from <a href="http://vasculitis.med.jhu.edu/typesof/cns.html"><strong>cerebral vasculitis</strong></a> (inflammation of the blood vessels in the brain).  House agrees with Foreman&#8217;s assessment and starts the patient on steroids.  He also orders a <a href="http://www.nlm.nih.gov/medlineplus/ency/article/003799.htm">brain angiogram</a> (an x-ray of the arteries in the brain), as well as an <a href="http://kidshealth.org/parent/general/sick/eeg.html">EEG</a> and a nerve biopsy, just to be sure.  Foreman convinces Chase to perform the angiogram, but he and Cameron suspect that the patient is suffering from <a href="http://www.mayoclinic.com/health/vitamin-d/NS_patient-vitamind"><strong>Vitamin D deficiency</strong></a>, so instead of checking the angiogram, they decide to start Hank on light therapy and intravenous vitamin replacement.  Unfortunately, while undergoing the light therapy, Hank develops a nosebleed and is found to have <a href="http://www.mayoclinic.com/health/petechiae/HQ01208">petechiae</a> on his legs.</p>
<p>Hank is now diagnosed with <a href="http://www.merck.com/mmhe/sec14/ch173/ch173h.html"><strong>disseminated intravascular coagulation</strong></a> (DIC, a weird, but very serious, condition, where the patient is both bleeding too much and clotting too much).  <strong><a href="http://www.emedicinehealth.com/sepsis_blood_infection/article_em.htm">Sepsis</a></strong> is suggested as a possible cause, but since he is showing none of the shock associated with sepsis, the idea is discarded.  <a href="http://www.merck.com/mmpe/sec14/ch167/ch167g.html"><strong>Bacteremia</strong></a> (bacteria in the blood) is suggested, but Cameron shoots it down suggesting instead <a href="http://www.nlm.nih.gov/medlineplus/ency/article/001349.htm">Meningococcemia</a> (<a href="http://bioweb.uwlax.edu/bio203/s2008/bingen_sama/">meningococcal bacteria</a> in the blood &#8212; really a subset of what Chase suggested).  House concurs with Cameron&#8217;s diagnosis and Hank is started on <a href="http://www.drugs.com/mtm/heparin.html">heparin</a> (a blood thinner, for the clots) and a broad spectrum antibiotic that covers meningococcus (but if you know which bacteria you&#8217;re treating, then you don’t need a broad spectrum antibiotic).</p>
<p>Hank does not improve and he starts to run a fever.  Taub suggests that he might have an infection hidden away in his <strong>sinuses</strong>, where the antibiotics have difficulty reaching, so Chase performs sinus surgery to clear out the sinuses.  Now Hank begins to complain of <strong>severe abdominal pain</strong> and Cameron discovers something on the exam (apparent <a href="http://www.healthatoz.com/healthatoz/Atoz/common/standard/transform.jsp?requestURI=/healthatoz/Atoz/ency/ascites.jsp">ascites</a> &#8212; fluid in the abdomen) that makes her diagnose <a href="http://www.merck.com/mmhe/print/sec10/ch135/ch135g.html"><strong>liver failure</strong></a>.  She suggests a <a href="http://www.oncolink.org/experts/article.cfm?c=3&#038;s=15&#038;ss=95&#038;id=2308">Klatskin tumor</a> (cancer of the <a href="http://en.wikipedia.org/wiki/Bile_duct">bile duct</a>), but it doesn&#8217;t quite fit the symptoms.  Foreman suggests that Hank has <a href="http://digestive.niddk.nih.gov/ddiseases/pubs/primarysclerosingcholangitis/index.htm">sclerosing cholangitis</a> (a disease that damages the bile ducts).  House agrees and an <a href="http://digestive.niddk.nih.gov/ddiseases/pubs/ercp/index.htm">ERCP</a> (an endoscopic exam of the bile duct and pancreas) is ordered &#8212; surprisingly it shows a mass in the common bile duct that ends up being a large clump of worms.  Hank apparently has <a href="http://emedicine.medscape.com/article/788652-overview"><strong>strongyloides</strong></a> (&#8221;whipworm&#8221;), and is given <a href="http://www.drugs.com/cons/mebendazole.html">mebendazole</a> to kill the worms.  </p>
<p>Once again, Hank&#8217;s condition dramatically worsens.  He develops severe <a href="http://www.mayoclinic.com/health/pulmonary-edema/DS00412/DSECTION=symptoms"><strong>pulmonary edema</strong></a> (fluid build up in the lungs).  Chase thinks it might be a combination of a hematological (blood) problem and cardiomyopathy (a heart problem).  Foremen suspects Hank has <a href="http://www.emedicinehealth.com/lymphoma/article_em.htm#Lymphoma%20Overview"><strong>lymphoma</strong></a>, with <a href="http://www.radswiki.net/main/index.php?title=Peritoneal_carcinomatosis">peritoneal carcinomatosis</a> (malignant spread of cancer across the abdomen) and <a href="http://www.ninds.nih.gov/disorders/paraneoplastic/paraneoplastic.htm">paraneoplastic syndrome</a> explaining his symptoms.  House sides with Foreman, and Hank is started on chemotherapy.  A short time later, Hank&#8217;s condition takes another turn for the worse when he starts <a href="http://www.medterms.com/script/main/art.asp?articlekey=8343">urinating blood</a>.  Next, his blood pressure and heart rate skyrocket, and he starts to bleed from his mouth.  He then suffers a cardiac arrest, but the team is able to stabilize him.  </p>
<p>The latest labs are back and show that Hank barely has any red blood cells, white blood cells, or platelets.  The differential diagnosis now includes <a href="http://www.nlm.nih.gov/medlineplus/ency/article/000343.htm"><strong>hypopituitarism</strong></a> (an underfunctioning pituitary gland), <a href="http://www.nlm.nih.gov/medlineplus/ency/article/000516.htm"><strong>renal cell carcinoma</strong></a> (a type of kidney cancer), or <strong>aleukemic leukemia</strong> (a <a href="http://www.emedicinehealth.com/leukemia/article_em.htm">leukemia</a> that is associated with low white blood counts instead of the normally high counts found in leukemia).  House tells the team that the latter is the most likely and orders them to ablate (destroy) Hank&#8217;s bone marrow in anticipation of a <a href="http://www.nlm.nih.gov/medlineplus/ency/article/003009.htm">bone marrow transplant</a>.  There is a lot of hemming and hawing about whether this is the right thing to do, since it could make Hank sicker or kill him, but at the last moment, Thirteen and Taub call in with the correct diagnosis:  <a href="http://findarticles.com/p/articles/mi_m0BUM/is_2_80/ai_76636539/">extraintestinal Crohn&#8217;s disease</a>.  According to them, Hank&#8217;s exceptionally clean childhood made him more likely to develop diseases such as Crohn&#8217;s, and the worms were actually helping him keep the disease in check.  Once the worms were killed off, the Crohn&#8217;s flared up with a vengeance.  With some methylprednisolone (steroids), Hank should get better &#8212; but the team wants to give him some worms again, just to make sure.</p>
<p><center><img src="http://politedissent.com/images/hline.gif" alt="headline" vspace="7"/></center></p>
<p><span style="font-style: italic; font-size: 90%;">I found no massive errors in tonight&#8217;s episode.  There was the usual: jumping randomly between unrelated diagnoses, bizarre test interpretation, and Chase being a specialist surgeon, but nothing horrible.  Of course, that&#8217;s not to say I have no complaints (as if!). As usual, minor complaints are in blue, nit-picking ones in green:</span></p>
<p><span class="hMid">Where exactly was the extraintestinal focus of the Crohn&#8217;s?</span></p>
<p><span class="hMid">Why did he develop a headache and photophobia in the beginning?  Was that the Crohn&#8217;s?  Why did everything suddenly worsen when he got in the hospital?  The steroids he was given for the vasculitis should have calmed down the Crohn&#8217;s.</span></p>
<p><span class="hMid">The strongyloides worms may not have been the cause of his disease, but their blockage of the bile duct would still cause serious problems for the patient.</span></p>
<p><span class="hMid">Again, no oncologist is going to start chemotherapy for cancer without a tissue diagnosis.</span></p>
<p><span class="hMid">Special precautions are taken for patients who are neutropenic (dangerously low in white blood cells, and thus more susceptible to infection) including gowning and gloving everybody in contact with the patient.  You do not roll them down the hospital&#8217;s common hallway without a mask and with the wife holding his hand.</span></p>
<p><span class="hMid">The CRP should have been significantly elevated with the Crohn&#8217;s disease (and the cerebral vasculitis too).</span></p>
<p><span class="hNit">While the ANA is generally strongly positive for certain types of autoimmune diseases, it is not found in every autoimmune condition (or even most autoimmune conditions), so a negative ANA does not mean there is no autoimmune disease (and positive ANAs in the absence of autoimmune pathology are also possible).</span></p>
<p><span class="hNit">How about checking the vitamin D level &#8212; an easy thing to do &#8212; before treating the patient.</span></p>
<p><span class="hNit">I noticed how they avoided actually saying the word &#8220;ascites&#8221; and instead chose a wordier explanation.  Probably because of their problem pronouncing it last time.</span></p>
<p><span class="hNit">Cameron shoots down Chase&#8217;s idea of bacteremia, but then suggests meningococcemia, a type of bacteremia.  The same argument she used against Chase would go against her as well.</span></p>
<p><span class="hNit">Why would you ablate the bone marrow without finding a donor first? (OK, maybe House was never planning on really following through with it, but why would the others go along?)</span></p>
<p><em>And now credit where credit is due:</em><br />
<img src="http://www.politedissent.com/images/check.jpg" alt="House 607" hspace="5"/>The hygiene hypothesis is a legitimate and controversial scientific theory concerning the rise in asthma and allergy rates in industrialized nations.  Some researchers link it to autoimmune diseases as well.<br />
<img src="http://www.politedissent.com/images/check.jpg" alt="House 607" hspace="5"/>Helminthic therapy &#8212; treatment of disease using intentional infestation of parasitic worms &#8212; is being tested in a variety of diseases, including Crohn&#8217;s/<br />
<img src="http://www.politedissent.com/images/check.jpg" alt="House 607" hspace="5"/>Shocking ventricular tachycardia, like Foreman did this episode, is the right treatment.</p>
<p><center><img src="http://politedissent.com/images/hline.gif" alt="House 607" vspace="7"/></center></p>
<p>The mystery was okay, but seemed to get lost in the shuffle as the show progressed.  I give it a <strong>B</strong>.  The final solution was a stretch, especially when you look back at the original symptoms.  It earns a <strong>C</strong>.  Overall, the medicine was better that it has been the past few weeks and earns another <strong>B</strong>.  The soap opera was decent as well.  I enjoy Tab and Thirteen, so I&#8217;m fine with having them back, though I know many will disagree. The soap opera earns still another <strong>B</strong>.</p>
<p><span class="hCad"><a href="http://politedissent.com/archives/3977">Last week&#8217;s  <cite>House </cite>review</a></span><br />
<span class="hCad"><a href="http://www.politedissent.com/house_pd.html">A list of all prior <cite>House </cite>reviews</a></span></p>
<p><center><span style="color: red; font-style: italic; font-size: 85%;">I should have the House Challenge Scores for the past two weeks up later this week, once I manage to rescue the scoring file from my toddler-damaged laptop.</span></center></p>
<div class="stag"><strong>Tags:</strong> <a href="http://politedissent.com/index.php?cat=8" rel="tag">television</a> <a href="http://politedissent.com/index.php?cat=4" rel="tag">medicine</a> <a href="http://www.politedissent.com/house_pd.html" rel="tag">house</a> <a href="http://politedissent.com/index.php?s=vasculitis&#038;submit=search" rel="tag">vasculitis</a> <a href="http://politedissent.com/index.php?s=lymphoma&#038;submit=search" rel="tag">lymphoma</a> <a href="http://politedissent.com/index.php?s=strongyloides&#038;submit=search" rel="tag">strongyloides</a> <a href="http://politedissent.com/index.php?s=leukemia&#038;submit=search" rel="tag">leukemia</a> <a href="http://politedissent.com/index.php?s=crohn&#038;submit=search" rel="tag">crohn&#8217;s disease</a></div>
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		<title>Just Another Day In The Clinic</title>
		<link>http://www.politedissent.com/archives/4015</link>
		<comments>http://www.politedissent.com/archives/4015#comments</comments>
		<pubDate>Mon, 16 Nov 2009 05:24:59 +0000</pubDate>
		<dc:creator>Scott</dc:creator>
				<category><![CDATA[Comics]]></category>
		<category><![CDATA[Medicine]]></category>

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Another thing I have to tell patients and their families at least a couple of time per week.
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			<content:encoded><![CDATA[<p><center><img src="http://www.politedissent.com/images/nov09/sanitarium.jpg" alt="scene from Action Comics" width="250" height="263" title="Never trust a psychiatrist, never mind one wearing a head mirror wrong"/></center></p>
<p>Another thing I have to tell patients and their families at least a couple of time per week.</p>
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		<title>Fringe — Episode 7 (Season 2): “Of Human Action”</title>
		<link>http://www.politedissent.com/archives/4006</link>
		<comments>http://www.politedissent.com/archives/4006#comments</comments>
		<pubDate>Fri, 13 Nov 2009 06:52:23 +0000</pubDate>
		<dc:creator>Scott</dc:creator>
				<category><![CDATA[Medicine]]></category>
		<category><![CDATA[TV]]></category>

		<guid isPermaLink="false">http://www.politedissent.com/?p=4006</guid>
		<description><![CDATA[An incredibly mediocre show that didn&#8217;t meet a cliche it didn&#8217;t like (except, unfortunately, the psychic nosebleed).  Sorry if the write up seems brief, but I&#8217;m really having a hard time caring about this show recently.

The Plot:The police are called for a kidnapping/hostage situation at the top of a parking garage where two guys [...]]]></description>
			<content:encoded><![CDATA[<p><em>An incredibly mediocre show that didn&#8217;t meet a cliche it didn&#8217;t like (except, unfortunately, the psychic nosebleed).  Sorry if the write up seems brief, but I&#8217;m really having a hard time caring about this show recently.</em></p>
<p><center><img src="http://politedissent.com/images/hline.gif" alt="Fringe #207" vspace="5"/></center></p>
<p><span style="font-weight: bold; color: darkred;">The Plot:</span>The police are called for a kidnapping/hostage situation at the top of a parking garage where two guys are holding a teen hostage in a car.  When the police arrive, they order the men out of the car.  The duo get out of the car and then strange things begin to happen: one cop backs up and throws himself off the garage, while his partner shoots the other cops and then herself.  The two guys get back in the car and drive off with the kid.  </p>
<p>The Fringe team is called in to evaluate the case.  Walter suspects that there is hypnotism of subliminal messages involved.  The team heads to Massive Dynamic because the kidnapped boy is the son of one of their top aerospace researchers.  By now, the two guys in the car have been identified as two local used car salesmen who had been upstanding citizens until now.  The kidnappers and teen stop by a convenience store and ob it.  A burly customer tries to intervene, but suddenly he is pouring scalding coffee over his head and the breaking the carafe over it.  The cashier tries to shoot the men, but finds himself picking up a key and inserting it into an outlet and shocking himself unconscious.</p>
<p>Walter has been performing an autopsy on the cop who shot the other cops and deduces that it was not hypnosis, but instead mind control.  He makes his deduction based on the fact that there are hematomas (pockets of leaked blood) on the surface of the brain, suggesting some mind/body conflict.  He then infers &#8212; for no good or logical reason &#8212; that this mind control must be done via the cochlear (hearing) nerve.</p>
<p>A call comes in from the kidnappers demanding two million dollars.  Meanwhile, Walter has concocted white noise headphones for the FBI troops to wear in the field which should block out any mind control.  At an abandoned factory, the teen&#8217;s father hands over a briefcase of money to the kidnapper, who then runs into a nearby building.  Agent Dunham follows. Meanwhile, Peter sees someone else running with the briefcase and follows, only to find the teen, Tyler, holding the briefcase.  It turns out Tyler&#8217;s the one with mind control and the others were nothing but patsies.  Unfortunately, Peter&#8217;s white noise headphones don’t protect him and Tyler orders him to drive the two of them out of town in the Bishop family roadster.</p>
<p>Peter tries to rebel, but Tyler forces him to drive the car as fast as it can go and plays chicken with a truck before Peter agrees to behave.  A little while later, they are pulled over by a policeman.  Tyler wants Peter to shoot the cop, but in the end, he lets Peter just knock him unconscious.  Finally, Tyler and Peter arrive at his mother&#8217;s house (by way of a strip club), where Tyler finally gets to meet the goal of his quest &#8212; his mother.  He believes that his father had driven her away and lied to him about her, but that turns out not to be the case, and when he learns she is married he has Peter pull out a gun and point it at her husband.  Luckily, Agent Broyles arrives and shoots Tyler with a taser &#8212; but it&#8217;s a bad shot.  Tyler has Peter shoot Broyles, and then he and Peter hop back in the family roadster and take off.  Agent Dunham, Astrid and Walter are following close behind, and when they get near off, Walter activates the EMP device he has been working on.  It knocks Tyler out for a split second, and that&#8217;s enough for Peter to realize what is going on and drive into a telephone pole.  He survives with a mild concussion, but Tyler is knocked unconscious and captured.</p>
<p><center><img src="http://politedissent.com/images/hline.gif" alt="Fringe #204" vspace="5"/></center><br />
<span style="font-weight: bold; color: darkred;">1.  Watching Too Many B-Movies, and Now I Need Some Popcorn</span><br />
Walter&#8217;s original suggestions were nonsense.  As Peter pointed out, hypnosis doesn&#8217;t work like that &#8212; and subliminal messages don&#8217;t work at all.</p>
<p><span style="font-weight: bold; color: darkred;">2.  La La La! I Can&#8217;t Hear You!</span><br />
Why go through all the elaborate set up of the white noise headphones instead of just using ear plugs?</p>
<p><span style="font-weight: bold; color: darkred;">3.  Bleeding On The Brain</span><br />
Hematomas don&#8217;t form with brain/body conflict.   There are certainly medical conditions with conflict between mind and body &#8212; somatization comes to mind &#8212; but none of them cause hematomas.  You could argue that the straining led to an increased blood pressure which popped the vessels, but high blood pressure related bleeds occur within the brain, not on the outside.<br />
<img src="http://politedissent.com/images/circ.jpg" alt="fringe" hspace="5" />That was a surprisingly intact brain for someone who received a bullet at point black range.</p>
<p><span style="font-weight: bold; color: darkred;">4.  On the AM Radio</span><br />
Why amplify the brain waves &#8212; that should have been the team&#8217;s first realization that something wasn&#8217;t kosher &#8212; why not just make better sensors?<br />
<img src="http://politedissent.com/images/circ.jpg" alt="fringe" hspace="5" />Amplifying the brain waves means that you are increasing the voltage within the brain itself, which is wonderful way of setting off a seizure.</p>
<p><span style="font-weight: bold; color: darkred;">5.  It&#8217;s Better Than The 10% Cliche, But Just Barely</span><br />
Brains are not computers.  Whenever someone uses this analogy, it&#8217;s a safe bet that they don&#8217;t understand brains or computers<br />
Having Tyler&#8217;s mother actually be a surrogate was a fairly clever twist &#8212; really the only one in an episode thick with clichés &#8212; but how does the doctor raise all five Tylers?  Are they frozen until needed?  Does he spend one day of the week with each one?</p>
<p><span style="font-weight: bold; color: darkred;">6.  The Blind Leading the Blind</span><br />
Geez, Olivia is a bad detective.  She already knows Tyler&#8217;s mother died when he was young, and then can&#8217;t figure out why he&#8217;s looking at records of women who died in car crashes fourteen years before.</p>
<p><span style="font-weight: bold; color: darkred;">7.  Crime And (Lack of) Punishment</span><br />
Why would Tyler get off with just seeing some psychiatrists?  That makes no sense at all, especially the way they explain it.  He was directly involved in the murder of five people, the maiming of three others, and at least three attempted murders.  He&#8217;s fifteen &#8212; old enough to be tried as an adult.</p>
<p><center><img src="http://politedissent.com/images/hline.gif" alt="Fringe #205" vspace="5"/></center></p>
<p><em>Why exactly am I still watching this show?  I&#8217;m sure I have much better things to do.</em></p>
<p><center><img src="http://www.politedissent.com/images/doomsday7.jpg" alt="Fringe Doomdsday Clock" width="200" height="200" title="At the tone, the time will be 11:57" /></center></p>
<div style="margin-left: 180px; text-align: left;">
<img src="http://www.politedissent.com/images/check.gif" alt="Fringe"/><font color="green">This week&#8217;s Fringe cipher was: ARRIVE.</font><br />
<img src="http://www.politedissent.com/images/check.gif" alt="Fringe"/><font color="green">A list of all previous Fringe reviews is available <a href="http://www.politedissent.com/fringe.html">here</a>.</font><br />
<img src="http://www.politedissent.com/images/check.gif" alt="Fringe"/><font color="green">Karl has <a href="http://blog.cordialdeconstruction.com/2009/11/12/minor-review-of-fringe-episode-7-season-2-%e2%80%9cof-human-action%e2%80%9d/">much more to say</a>.</font></div>
<p><center></p>
<div class="stag"><strong>Tags:</strong> <a href="http://politedissent.com/index.php?cat=8" rel="tag">television</a> <a href="http://politedissent.com/index.php?cat=4" rel="tag">medicine</a> <a href=http://politedissent.com/index.php?s=fringe&#038;submit=search" rel="tag">fringe</a> <a href="http://politedissent.com/index.php?s=mind+control&#038;submit=search" rel="tag">mind control</a> <a href="http://politedissent.com/index.php?s=hypnosis&#038;submit=search" rel="tag">hypnosis</a> <a href="http://politedissent.com/index.php?s=subliminal&#038;submit=search" rel="tag">subliminal</a></div>
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		<title>It’s Like Looking In A Mirror</title>
		<link>http://www.politedissent.com/archives/4002</link>
		<comments>http://www.politedissent.com/archives/4002#comments</comments>
		<pubDate>Thu, 12 Nov 2009 05:26:49 +0000</pubDate>
		<dc:creator>Scott</dc:creator>
				<category><![CDATA[Comics]]></category>
		<category><![CDATA[Medicine]]></category>

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		<description><![CDATA[
I swear, I have this same conversation with at least two or three patients a day.  When will the horror of water allergy end?
]]></description>
			<content:encoded><![CDATA[<p><center><img src="http://www.politedissent.com/images/nov09/aquaman.jpg" alt="scene from Adventure Comics #152" border="1" width="250" height="233"  "Stethoscope, pens, and a head mirror.  Yep, he's a doctor all right."/></center></p>
<p>I swear, I have this same conversation with at least two or three patients a day.  When will the horror of water allergy end?</p>
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		<title>Happy Veteran’s Day</title>
		<link>http://www.politedissent.com/archives/3993</link>
		<comments>http://www.politedissent.com/archives/3993#comments</comments>
		<pubDate>Wed, 11 Nov 2009 11:06:35 +0000</pubDate>
		<dc:creator>Scott</dc:creator>
				<category><![CDATA[Comics]]></category>
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A medical and a military reference all in one cover, courtesy of Punch Comics #17 (April 1946)
]]></description>
			<content:encoded><![CDATA[<p><center><img src="http://www.politedissent.com/images/nov09/punch_17.jpg" alt="cover, Punch #17" title="Happy Veteran's Day" border="1"/><br />
<span style="font-size: 85%;">A medical and a military reference all in one cover, courtesy of <strong><a href="http://www.comics.org/issue/5038/">Punch Comics #17</a></strong> (April 1946)</span></center></p>
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		<title>Tuesday PSA: Superman’s Code for Buddies</title>
		<link>http://www.politedissent.com/archives/3988</link>
		<comments>http://www.politedissent.com/archives/3988#comments</comments>
		<pubDate>Wed, 11 Nov 2009 04:52:45 +0000</pubDate>
		<dc:creator>Scott</dc:creator>
				<category><![CDATA[Comics]]></category>

		<guid isPermaLink="false">http://www.politedissent.com/?p=3988</guid>
		<description />
			<content:encoded><![CDATA[<p><a href="http://www.politedissent.com/images/nov09/buddies.html" onclick="window.open('http://www.politedissent.com/images/nov09/buddies.html', 'popup', 'width=630, height=870,  scrollbars=yes,  resizable=yes, toolbar=no, directories=no, location=no, menubar=no, status=no, left=0, top=0'); return false"><img src="http://politedissent.com/images/nov09/code.jpg" alt=Superman's Code for Buddies. Click for the full page." title="Superman's Code for Buddies. Click for the full page." align="right" hspace="10" width="252" height="200"/></a>With Veteran&#8217;s Day tomorrow, I looked hard to find a public service ad that discussed veterans.  I was truly surprised that with all the public service ads DC produced in the 1940s, &#8217;50s, and &#8217;60s, there don&#8217;t seem to be any about veterans &#8212; or the armed forces at all.  This PSA, from April 1950, was the closest thing I could find because it at least includes a scene set in a veteran&#8217;s cemetery.  </p>
<p>The PSA&#8217;s actual theme is tolerance for all religions &#8212; which is certainly a sound concept, but I would&#8217;ve liked it better had it acknowledged religions other than Christianity and Judaism &#8212; or taken it one step further and at least mentioned other options such as atheism.  But I suspect that would have been a little too progressive for a 1950s mainstream comic book.</p>
<p><center><big><em>Click on the image for the full ad</em></big></center></p>
<p>This PSA was found <strong><a href="http://www.comics.org/issue/8226/">Adventure Comics #151</a></strong>, and can be found in other DC comics from April 1950.  This ad was written by Jack Schiff, with art by Al Plastino.</p>
<p><center><img src="http://politedissent.com/images/cad.jpg" alt="More PSAs" hspace="5"/><a href="http://www.politedissent.com/index.php?s=psa&#038;submit=search">More PSAs</a></p>
<div class="stag"><strong>Tags:</strong> <a href="http://politedissent.com/index.php?cat=2" rel="tag">comics</a> <a href="http://www.politedissent.com/index.php?s=psa&#038;submit=search" rel="tag">psa</a> <a href="http://www.politedissent.com/index.php?s=buzzy&#038;submit=search" rel="tag">superman</a> <a href="http://www.politedissent.com/index.php?s=old+folks&#038;submit=search" rel="tag">superman</a> <a href="http://www.politedissent.com/index.php?s=schiff&#038;submit=search" rel="tag">jack schiff</a> <a href="http://www.politedissent.com/index.php?s=plastino&#038;submit=search" rel="tag">al plastino</a></div>
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		<title>House — Episode 6 (Season 6): “Known Unknowns”</title>
		<link>http://www.politedissent.com/archives/3977</link>
		<comments>http://www.politedissent.com/archives/3977#comments</comments>
		<pubDate>Tue, 10 Nov 2009 06:03:42 +0000</pubDate>
		<dc:creator>Scott</dc:creator>
				<category><![CDATA[Medicine]]></category>
		<category><![CDATA[TV]]></category>

		<guid isPermaLink="false">http://www.politedissent.com/?p=3977</guid>
		<description><![CDATA[This episode of House started well but collapsed under the weight of its ridiculous medicine in a surprisingly short period of time.  The soap opera was well done and enjoyable, though

Jordan, a sixteen year-old girl, and her best friend bluff their way into a band&#8217;s post-concert party.  The next morning when they are [...]]]></description>
			<content:encoded><![CDATA[<p><em>This episode of House started well but collapsed under the weight of its ridiculous medicine in a surprisingly short period of time.  The soap opera was well done and enjoyable, though</em></p>
<p align="center"><img src="http://politedissent.com/images/spoiler.gif" alt="Spoiler Alert!!" /></p>
<p>Jordan, a sixteen year-old girl, and her best friend bluff their way into a band&#8217;s post-concert party.  The next morning when they are regaling their other friends with the details of the  night (including alcohol, marijuana, and skinny dipping), her friends notice that Jordan&#8217;s ankles are very swollen.  Seconds later, her fingers become swollen too, and then she collapses on the floor.</p>
<p>Admitted to Princeton-Plainsboro, House is convinced that Jordan has <a href="http://www.medicinenet.com/rhabdomyolysis/article.htm"><strong>rhabdomyolysis</strong></a> (muscle damage, often caused by a crush injury.  He thinks she injured herself climbing the fence to the pool to go skinny dipping).  The rest of the team suggests that she may have a <strong><a href="http://hcd2.bupa.co.uk/fact_sheets/html/Deep_Vein_Thrombosis.html">deep vein thrombosis</a></strong> (a blood clot), <a href="http://www.intelihealth.com/IH/ihtIH/WSIHW000/9339/9452.html"><strong>anaphylaxis</strong></a> (a life-threatening allergic reaction), or even a <strong>heart condition</strong>, but House maintains that Jordan must have rhabdomyolysis.  Tests reveal that Jordan&#8217;s muscle enzymes are elevated (a sign of rhabdomyolysis), but the scans show no sign of the muscle injury House was suspecting.</p>
<p>House now looks over the labs and notices that Jordan has a <a href="http://www.myoptumhealth.com/portal/Health+Hubs/item/Hypokalemia%3A+When+Your+Potassium+Is+Too"><strong>low potassium</strong></a>.  He has her air drum (like air guitar, only drumming), but she can only drum for a minute or two before her arms are too tired to lift.  House states that this muscle weakness is a sign of low potassium, and since she would have had a low potassium the previous night as well, there was no way she had the muscle strength to climb the pool fence.  In other words, he accused her of lying about what happened.  Later, Jordan and her friend admit to Cameron and Chase that in reality, they only wanted to go to the party because their favorite comic book/movie writer Jeffrey Keener would be there.  They then proceeded to stalk him for the next few hours (going where he went, eating what he ate, etc), before finally going to bed.</p>
<p>The differential now consists of an unknown <strong><a href="http://www.mayoclinic.com/health/food-allergy/DS00082">food allergy</a></strong>, plus Cameron thinks that Jordan may be <a href="http://emedicine.medscape.com/article/286485-overview"><strong>bulimic</strong></a>.  They run a scan to look for a <a href="http://emedicine.medscape.com/article/187134-overview">Mallory-Weiss tear</a> (a rip in the esophagus seen in people who vomit frequently, like bulimics), and when they don&#8217;t find one, decide that she isn&#8217;t bulimic.  As they finish the test, Jordan&#8217;s blood pressure drops suddenly and then she flatlines.  Foreman starts CPR (good for him).  Chase announces that Jordan has <a href="http://www.nlm.nih.gov/medlineplus/ency/article/000194.htm"><strong>cardiac tamponade</strong></a> (the pericardial sac &#8212; the membrane around the heart &#8212; has become filled with so much fluid the heart can no longer beat correctly) and he plunges a needle into her chest to draw off the blood around the heart and relieve the problem.  Somehow, this brief moment of tamponade has severely damaged (&ldquo;constricted&rdquo;) her heart, necessitating use of antiarrhythmic medications (drugs to prevent abnormal heart rhythms).  Since Jordan&#8217;s blood pressure drop was sudden, House decides that this means she has an <em>acute </em>problem, not a <em>chronic </em>one.  Therefore, the most likely diagnoses are <strong>toxin exposure</strong> or <strong>infection</strong>, but the team still needs to figure out which toxin or which infection.</p>
<p>Things continue to worsen for Jordan.  She tells the team about stopping by Bruce Springsteen&#8217;s house and playing guitar with him .  She is lying and does not even realize that she is doing it.  Additionally, Foreman notices blood dripping from her ear and announces to her friend that <strong>bleeding in her brain</strong> is affecting her thalamus and this is causing her to lie.  (When did he get an MRI to determine this?  And why would bleeding in the thalamus &#8212; in the center of the brain &#8212; leak out the ear?  Did she somehow rupture her eardrum too?)</p>
<p>The team reviews the videotapes from the hotel that night and discover that Jordan sneaked out of her room briefly in the middle of the night.  They see her a few minutes later carrying Keener&#8217;s journal.  He apparently left it in the restaurant and she went back to get it.  They figure that she must have stopped by his room to return the journal and maybe something happened to her there.  Chase and Cameron confront Keener in his hotel room &#8212; he shuts the door in their face.  Cameron now suspects that Jordan was slipped some <a href="http://www.streetdrugs.org/html%20files/Rohypnol.html"><strong>roofies</strong></a> (a slang term for Rohypnol, an alleged <del>common</del> date rape drug) and wants to start her on <a href="http://en.wikipedia.org/wiki/Flumazenil">Flumazenil</a> (a medication which reverses the effects of Rohypnol and similar drugs).  When they return to the hospital, they find Foreman frantically working on Jordan. He tells them that she has been bleeding behind her kidneys and has required multiple units of blood.  Cameron thinks it looks like a &#8220;toxic reaction.&#8221;</p>
<p>Cameron realizes that they must figure out what really happened to Jordan that night.  Her plan is to give Jordan <a href="http://en.wikipedia.org/wiki/Amobarbital"><strong>Amobarbital</strong></a> &#8212; i.e.truth serum &#8212; so they can discover the truth.  Jordan is given the drug, and under questioning, admits that she went to Keener&#8217;s room where he invited her in and gave her <a href="http://www.nida.nih.gov/Infofacts/ecstasy.html"><strong>Ecstasy</strong></a> &#8212; only it didn’t have the same effect on her that Ecstasy usually does &#8212; this  pill made her sleepy.  She then begins telling the team how Keener started to touch her.  As her father gets more and more upset, Foreman points out that the scans indicate &#8220;increased periorbital blood flow&#8221; meaning that everything she just said is a lie.</p>
<p>Most of the action now shifts upstate, where Cuddy, House, and Wilson are at a medical conference.  At one point, the team talks to Wilson and tells him that since Keener travels with his dog, Jordan may have come down with <a href="http://www.cehs.siu.edu/fix/medmicro/ricke.htm">Rickettsia</a> (not the name of an infection <em>per se</em>, but a genus of tick-borne bacteria that cause such diseases as typhus and rocky mountain spotted fever).  A short time later, in the middle of an argument with Wilson, House has his <em>Eureka!</em> moment and calls the team.  He announces that Jordan has <a href="http://www.textbookofbacteriology.net/V.vulnificus.html"><strong><em>Vibrio vulnificus</em></strong></a>, a not uncommon bacterial contaminant of the raw oysters Jordan ate.  For most people, the bacteria present no problem (or mild nausea and vomiting), but Jordan also has <strong><a href="http://digestive.niddk.nih.gov/ddiseases/pubs/hemochromatosis/">hemochromatosis</a></strong>.  According to House, this made her more susceptible to the contaminated oysters.  The <em>Vibrio </em>infection explains her initial symptoms.  Then the team, thinking she had bulimia, started her on iron-containing vitamins, which worsened the symptoms of the hemochromatosis (by causing iron overload), resulting in liver damage and bleeding.  They gave her transfusions, which again worsened her symptoms (more iron overload).  However, with the right diagnosis and some Cetazidime (an antibiotic for the Vibrio) and chelation (for the excess iron), she should be as good as new.</p>
<p><center><img src="http://politedissent.com/images/hline.gif" alt="headline" vspace="7"/></center></p>
<p><span style="font-style: italic; font-size: 90%;">Tonight&#8217;s episode was rife with errors, far worse than usual.  I did my best, but I&#8217;m sure some obvious one slipped by.  As usual, major complaints are in red, minor in blue, nit-picking in green:</span></p>
<p><span class="hBig">The truth serum idea was simply ridiculous.  Amobarbital does not work like Cameron explained, and it is far from foolproof &#8212; for example, it&#8217;s easy to create false memories (and the questioner Cameron clearly had a preconceived belief of what happened to Jordan).<br />
<span style="margin-left: 10px;"><img src="http://politedissent.com/images/circ.jpg" alt="defib" hspace="5"/>Telling truth from lies is not nearly as black and white and Foreman makes it seem.  You can’t look at an fMRI report and definitively state &#8220;she was lying the entire time&#8221; like he did.  But it sure would make police interrogations and court a lot easier if it worked as easily as Foreman implies.</span><br />
<span style="margin-left: 10px;"><img src="http://politedissent.com/images/circ.jpg" alt="defib" hspace="5"/>Anyway, where is the fMRI?  Jordan was in a bed in the center of the room.  There was no MRI equipment in sight.  Nothing to read the &#8220;increased blood flow&#8221; he mentions.</span></span></p>
<p><span class="hBig">Cardiac tamponade or not, you don’t just plunge a needle and syringe blindly into the chest &#8212; you&#8217;re likely to do more harm than good.  Yes, you can perform a needle pericardiocentesis, but it&#8217;s more involved than &#8220;plunge and pray.&#8221;<br />
<span style="margin-left: 10px;"><img src="http://politedissent.com/images/circ.jpg" alt="defib" hspace="5"/>Why would 20 seconds of tamponade cause a permanent conduction problem in the heart?</span></span></p>
<p><span class="hBig">A day or two of iron supplementation is not enough to cause that severe liver damage in a patient with hemochromatosis.  And apparently it kicked in really fast, because it bled into her pericardial sac mere minutes after suggesting the diagnosis of bulimia, let alone giving her vitamins with iron.</span></p>
<p><span class="hBig">Jordan&#8217;s symptoms do not match <em>Vibrio </em>at all.  For starters, she has no gastrointestinal symptoms from what is essentially food poisoning.</span></p>
<p><span class="hBig">When did Foreman get an MRI to determine that Jordan had &#8220;bleeding into her thalamus?&#8221;  And why would bleeding in the thalamus &#8212; in the center of the brain &#8212; leak out the ear?  Did she suffer head trauma which disrupted her ear canal and also ruptured her eardrum?)</span></p>
<p><span class="hMid">Rhabdomyolysis can have other causes other that a direct muscle injury, so not seeing a specific injury on the scan means little (for example, many marathon runners end up with some rhabdomyolysis by the end of their race, but it’s not a single muscle, but most of them, so a scan would show nothing)</span></p>
<p><span class="hMid">Not everyone with bulimia develops Mallory-Weiss tears, in fact, most don&#8217;t.  So not seeing a tear does not mean she is not bulimic.</span></p>
<p><span class="hMid"><em>Edema </em>is swelling of soft tissue.  <em>Effusion </em>is the swelling of a joint.  They are not the same thing and the terms should not be used interchangeably. A halfway decent physical exam, especially on someone as skinny as Jordan, should easily tell them apart.</span></p>
<p><span class="hNit">Assuming Jordan did receive Rohypnol, the flumazenil, a benzodiazepine antidote, is a reasonable choice.  But by the time Cameron would have given the drug to her, the rohypnol would have been long gone from her system.</span></p>
<p><span class="hNit"><em>Rickettsia </em>is a genus of bacteria, not a specific disease.  </span></p>
<p><span class="hNit">Rhabdomyolysis is very hard on the kidney.  I would think twice, and then a third time, before giving such a person IV contrast (also very hard on the kidneys).</span></p>
<p><center><img src="http://politedissent.com/images/hline.gif" alt="House, Episode 18, Season 5" vspace="7"/></center></p>
<p>I thought the medical mystery itself, and the confusion of the always changing history, was intriguing this week and deserves a <strong>B+</strong>.  It goes downhill from there.  The final solution did not fit the mystery at all &#8212; either solution &#8212; and earns a <strong>D-</strong>.  The medicine overall was a complete mess, with scattershot diagnoses, ideas abandoned for sloppy reasons, and missing equipment.  It earns a solid dismal <strong>F</strong>.  The soap opera was a bright spot &#8212; especially all the scenes at the conference &#8212; and earns an <strong>A</strong>.</p>
<p><span class="hCad"><a href="http://politedissent.com/archives/3816">Last week&#8217;s  <cite>House </cite>review</a></span><br />
<span class="hCad"><a href="http://www.politedissent.com/house_pd.html">A list of all prior <cite>House </cite>reviews</a></span></p>
<div class="stag"><strong>Tags:</strong> <a href="http://politedissent.com/index.php?cat=8" rel="tag">television</a> <a href="http://politedissent.com/index.php?cat=4" rel="tag">medicine</a> <a href="http://www.politedissent.com/house_pd.html" rel="tag">house</a> <a href="http://politedissent.com/index.php?s=vibrio&#038;submit=search" rel="tag">vibrio</a> <a href="http://politedissent.com/index.php?s=hemochromatosis&#038;submit=search" rel="tag">hemochromatosis</a> <a href="http://politedissent.com/index.php?s=amobarbital&#038;submit=search" rel="tag">amobarbital</a> <a href="http://politedissent.com/index.php?s=roofie&#038;submit=search" rel="tag">roofie</a> <a href="http://politedissent.com/index.php?s=tamponade&#038;submit=search" rel="tag">tamponade</a></div>
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		<title>The Return of Jor-El’s Super-Power Pills</title>
		<link>http://www.politedissent.com/archives/3960</link>
		<comments>http://www.politedissent.com/archives/3960#comments</comments>
		<pubDate>Mon, 09 Nov 2009 05:12:15 +0000</pubDate>
		<dc:creator>Scott</dc:creator>
				<category><![CDATA[Comics]]></category>
		<category><![CDATA[Medicine]]></category>

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		<description><![CDATA[The criminal who discovered Jor-El&#8217;s super-power pills has escaped from prison and rumor has it that he has hidden one last pill somewhere.  Superman, Batman, and Robin rush off to capture him before he can reach the pill, but the criminal slips by them.  Batwoman (the mini-skirted all-but-incompetent Silver Age Batwoman, not the [...]]]></description>
			<content:encoded><![CDATA[<p>The criminal who discovered <a href="http://www.politedissent.com/archives/3906">Jor-El&#8217;s super-power pills</a> has escaped from prison and rumor has it that he has hidden one last pill somewhere.  Superman, Batman, and Robin rush off to capture him before he can reach the pill, but the criminal slips by them.  Batwoman (the mini-skirted all-but-incompetent Silver Age <a href="http://www.politedissent.com/archives/323">Batwoman</a>, not the current one) decides she wants in on the act.  She manages to find the villain and grabs his pill before he can swallow it.  She then swallows the pill herself &#8212; and with her new super-powers &#8212; returns the criminal to prison.</p>
<p>Now that Batwoman has super-powers for the next twenty-four hours, how do you think she decides to use them?  Stop crime, right?  Wrong.  She decides she is going to use her super-powers to discover the identities of Batman, Robin, and Superman.</p>
<p>So, not only does Batwoman &#8212; an alleged super-hero &#8212; not use her new powers to fight crime, but instead she uses them to betray the confidence of other heroes.  Nice going.</p>
<p>Batwoman follows Batman and Robin as they drive around Gotham City in the Batmobile.  They give her the slip &#8212; or at least they think they do &#8212; but as soon as they drive into the Batcave, there she is waiting for them.  She tells the duo she used her x-ray vision to find the Batcave, and now, based on the mansion above the cave, she knows their identity.  Next she sets out to discover Superman&#8217;s.</p>
<p>Batwoman catches up with Superman when he is saving a small town from an avalanche.  She follows him, hoping he&#8217;ll lead her to his secret identity.  He tries to scare her away by flying through a lightning storm, walking through an artillery proving ground, and floating over Niagara Falls, but none of it works.  Finally, he decides what his only option is to expose her to the thing every woman is scared of: mice.</p>
<p><center><img src="http://www.politedissent.com/images/nov09/wf_90_1.jpg" alt="scene from World's Finest Comics #90" border="1" width="258" height="250" title="And the mice aren't too thrilled about Batwoman either." width="258" height="250"/></center></p>
<p>Superman&#8217;s plan works and he sneaks out through the basement, drilling through the ground, making sure to stay below veins of lead-bearing ores, but Batwoman is able to track him by sound.  When he emerges from the ground, she tells him that he has fallen into her trap.  She&#8217;s lured him away from his job for the whole afternoon, and since she saw what block of Metropolis he came from, all she has to do now is find the office in that block where a worker has been missing all afternoon.  When she shows up at the Daily Planet, Lois tells her everyone has been there the whole day (but she only mentions Clark, Jimmy, and Perry &#8212; so in the Silver Age the Daily Planet apparently only employed four people).  At this point, Batwoman&#8217;s twenty-four hours of powers are up and she admits defeat in figuring out Superman&#8217;s identity &#8212; but at least she knows the true identities of Batman and Robin.  Not so fast, says Superman:</p>
<p><center><img src="http://www.politedissent.com/images/nov09/wf_90_2.jpg" alt="scene from World's Finest Comics #90" border="1" title="No the Batmobile's not flying, Superman is carrying it."/></center></p>
<p>And just in case you were wondering:</p>
<p><center><img src="http://www.politedissent.com/images/nov09/wf_90_3.jpg" alt="scene from World's Finest Comics #90" border="1" width="328" height="250" title="Lois thought, 'Clark seems unusually witty today...'"/></p>
<p><span style="font-size: 85%; font-style: italic;">Story from <strong><a href="http://www.comics.org/issue/13790/">World&#8217;s Finest #90</a></strong> (September/October 1957), by Edmond Hamilton and Dick Sprang</span></p>
<div class="stag"><strong>Tags:</strong> <a href="http://politedissent.com/index.php?cat=2" rel="tag">comics</a> <a href="http://politedissent.com/index.php?cat=4" rel="tag">medicine</a> <a href="http://www.politedissent.com/index.php?s=kryptonite&#038;submit=search" rel="tag">kryptonite</a> <a href="http://www.politedissent.com/index.php?s=superman&#038;submit=search" rel="tag">superman</a> <a href="http://www.politedissent.com/index.php?s=batman&#038;submit=search" rel="tag">batman</a> <a href="http://www.politedissent.com/index.php?s=robin&#038;submit=search" rel="tag">robin</a> <a href="http://www.politedissent.com/index.php?s=batwoman&#038;submit=search" rel="tag">batwoman</a> <a href="http://www.politedissent.com/index.php?s=jor-el&#038;submit=search" rel="tag">jor-el</a> <a href="http://www.politedissent.com/index.php?s=pills&#038;submit=search" rel="tag">pills</a></div>
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