- Hey guys, you requested House MD.
- Do I get bonus points if I act like I care?
- Let's get started.
(relaxed music)
This reminds me of where I grew up in Brooklyn.
Or is this a jail?
(laughing)
- Why are you late?
- I feel like you won't like the answer.
- I already know the answer.
- I missed the bus.
- I don't doubt it, no bus stops near Brad's?
- Every medical show has to start off
with some kind of sexual thing.
Medicine is so exciting as it is,
why does there have to be sex?
Calm down, stop having sex for a second.
- You should never keep anything from your parents.
And I told mine- (slurring)
(kids laughing)
(sighing)
(slurring)
(kids laughing)
- Oh.
(slurring)
(kids laughing)
- Are we having a stroke?
Slurred speech, classic sign of a stroke.
(slurring)
Oh, problems with moving the arms.
- C
- Call 911
- A-L
H-E
The!
We know that word, the!
- Oh no!
(grunting)
- Oh, that's a seizure.
She's having a general tonic-clonic seizure.
- [James] 29 year old female,
first seizure, one month ago,
lost the ability to speak.
Babbled like a baby,
aggressive deterioration of mental status.
- [House] See that, they all assume that I'm a patient
because of this cane.
- [James] So put on a white coat like the rest of us.
- [House] I don't want them to think I'm a doctor.
- [James] You see where the administration
might have a problem with that attitude?
- [House] People don't want a sick doctor.
- Not wearing your white coat,
I guess it's not really a big deal
because sometimes I go without my white coat
and just wear my stethoscope.
It's really for infectious purposes only,
so that if you get any kind of germs on you,
you don't bring it back home to your family.
Or if, obviously, some blood splatters on you
or some other bodily fluid, I guess.
- Brain tumor, she's gonna die, boring.
- That was a little cold.
- She's 29, whatever she's got is highly unlikely.
- Protein markers for the three most prevalent
brain cancers came up negative.
- Tumor markers for brain cancer?
That's not how we diagnose brain tumors.
We use imaging.
That's the gold standard for brain tumors,
obviously in addition to biopsy if needed,
but tumor markers are not a way to rule out a cancer.
- And she's not responding to radiation treatment.
- None of which is even close to this positive.
- Medically, I'm very confused.
There's a patient who had a seizure.
They think that she has a tumor,
they did some lab work.
Doesn't show she has a tumor.
They're giving her radiation even though
that they don't see a tumor.
I could not be more confused right now,
or this totally doesn't make sense medically.
- Shouldn't we be speaking to the patient
before we start diagnosing?
- Is she a doctor?
- No, but--
- Everybody lies.
- Doctor House doesn't like dealing with patients.
- Isn't treating patients why we became doctors?
- No, treating illnesses is why we became doctors.
Treating patients is what makes most doctors miserable.
- So you're trying to eliminate the humanity
from the practice of medicine?
- If we don't talk to them, they can't lie to us.
- Excuse me Doctor House.
You can have a good conversation with patients.
You don't need to believe every word they say.
You can be honest, you can say you don't know,
but give a plan of what you're doing about not knowing.
So basically how you're getting to the answer.
- First thing of medical school,
"If you hear hoofbeats, you think horses, not zebras."
- Very common phrase.
- Medical school.
- That and Treton could have screwed up the blood test.
I assume its a corollary that if people lie
that people screw up.
- Redraw the blood tests and get her scheduled
for that contrast MRI ASAP.
Let's find out what kind of zebra we're treating here.
- So a contrast MRI basically allows you to see
what blood vessels are doing within the brain.
The fact that they're going to a lab
and questioning if the lab is accurate,
we do do that occasionally,
but that's not the first thing we think about.
I guess 'cause this case is more complex.
- I was expecting you in my office 20 minutes ago.
- Really? Well that's odd, because I had no intention
of being in your office 20 minutes ago.
- You think we have nothing to talk about?
- No, just can't think of anything I'd be interested in.
- I sign your paychecks.
- I got tenure.
- I can still fire you if you're not doing your job.
- I'm here from nine to five.
- Your billings are practically non-existent.
- Rough year.
- You ignore requests for consults.
- I call back sometimes I misdial.
- You're six years behind
on your obligations to this clinic.
- See, I was right, this doesn't interest me.
- Six years.
Times three weeks.
You owe me better than four months.
- It's five o'clock, I'm going home.
- Doctors don't work nine to five's.
We have crazy schedules.
If someone that's more senior to us,
obviously like our boss, like she is in this case,
tells you to get something done, you're getting it done.
But also because we have a love for the job.
We wanna treat patients,
I don't know why he's being this sarcastic guy,
but I will say it's really funny.
- I'm angry!
You're risking a patients life!
- I assume those are two separate points.
- You showed me disrespect, you embarrassed me
and as long as I work here you have no--
- Is the yelling designed to scare me,
because I'm not sure-- - I love her.
- What it is I'm supposed to be scared of.
More yelling?
That's not scary.
That you're gonna hurt me?
That's scary, but I'm pretty sure I can outrun ya.
(yelling)
- 'Kay.
That's cool that he's popping pills on the job.
Oh this is in Jersey, Plainsboro.
I work in New Jersey.
- All right Rebecca,
I know you may feel a little claustrophobic in there,
but we need you to remain still.
- It's very true that people get claustrophobic in MRI's,
you have to lay there for an extended period of time.
The noise is very loud.
So there are times that I have to pre-medicate my patients
and give them a dose of a benzodiazepines,
like Xanax, most commonly,
that you're probably familiar with.
(loud clicking)
Yeah it's really loud, it's even louder than this.
(loud banging)
- I don't feel so good.
- [Doctor] It's all right, just try to relax.
(loud whirring)
(choking)
- Oh, is she having another seizure?
- Rebecca?
(choking)
Rebecca?
- Is she choking?
(choking)
- Is she having an anaphylactic attack to the contrast?
- Rebecca?
Get her out of there.
- She probably fell asleep, she's exhausted.
- She was claustrophobic 30 seconds ago,
she's not sleeping, we gotta get her out of there.
- It'll just be another minute.
- She's having allergic reaction to gadolinium,
she'll be dead in two minutes.
- Oh no!
Get her out, Epipen into the upper thigh, quick!
- She's ashen.
- She's not breathing, (mumbling)
- Come on!
I can't ventilate.
- Too much edema.
Where's the surgical airway tube.
- You're gonna need to go in the neck
and do a tracheostomy.
(heavy breathing)
- Did he give her the Epi? I didn't see it.
(intense music)
Okay that's way too big of an incision.
Okay, not exactly how that goes.
If you're allergic to the contrast
that they gave for the MRI,
it's possible that you can get this anaphylactic attack,
which means that your airway starts closing down.
Basically your throat swells up to the point
where you can no longer oxygenate.
Some people also vomit,
some people get very nauseous, blood pressure drops.
Her airway closed up to the point where she couldn't breathe
but because it's her throat closing up and swelling,
if you make an incision in the trachea right here
where there's a soft little spot for an opening,
you can continue helping the patient breathe.
I'm gonna call some inaccuracies here.
If a patient turns blue like that,
you're hitting a code blue.
There's an emergency team coming,
nurses, doctors, respiratory therapists.
You also gotta get IV's set,
you gotta figure out why the patients heart stopped
or stopped breathing.
There's a lot more that has to happen.
You don't just automatically assume
it has something to do with the contrast that you gave.
And he's still popping pills!
What is he popping?
I hope those are Advil.
- You actually want me to talk to the patient?
Get a history?
- We need to know if there's some genetic
or environmental cause
as to generate an inflammatory response.
- I thought everybody lied?
- Truth begins in lies.
- Okay.
So why did you tell him not to talk
to the patient initially Doctor House?
"Truth begins in lies."
Just means that in order to find out the truth,
you have the person lie to you,
and from there you can then start making a deduction
on what part they're lying about.
So you need to hear the lie.
That's why it definitely makes sense
to always talk to patients first,
regardless if you believe
that they're telling the truth or not.
- What are you doing?
- Painkillers.
- Oh, for your leg?
- No, 'cause they're yummy.
You want one?
They'll make your back feel better.
- No, don't do it!
That's how the opioid crisis started, House!
- Why are you so afraid of making a mistake?
- Because I'm a doctor.
- Yes. - Because,
When we make mistakes people die.
- Yes.
- Come on.
People used to have more respect for cripples, you know.
They didn't really.
(laughing)
- I can't see.
- Uh oh.
- I can't see.
(dramatic music)
- She's having a seizure again.
- Little help in here!
(intense music)
- So turning a patient on their side
is the smartest move because you want them to,
if they're gonna vomit, they don't aspirate.
- Can you arrange these to tell a story?
(sad music)
- This is a type of neurological testing
to see if the person can follow a series of events.
- Had a couple headaches last month.
Mild fever.
Sometimes I can't sleep and I have trouble concentrating.
- Apparently not while researching
this stuff on the internet.
- I was thinking it also might be fibromyalgia.
- Excellent diagnosis.
- Is there anything for that?
- Do you know I think there just might be.
I need 36 Vicodin and change for a dollar.
- And change.
- 36 Vicodin and change for a dollar?
- Oh, placebo!
(laughing)
He's gonna give him sugar pills.
Oh and he's stealing the Vicodin for himself.
Again, obviously Doctor's don't swap out medications.
If we prescribe something to the patient,
we send an order to pharmacy
and the pharmacists fill the order,
and we don't replace it with sugar pills for placebo effect.
- So you didn't find anything?
- Everything I found was in my--
- You found ham.
- Uh oh.
- So?
- Where there's ham, there's pork.
Where there's pork, there's neurocysticercosis.
- That's the condition.
Bum bum bam!
Tapeworms!
- It fits.
It's perfect.
It explains everything.
- But it proves nothing.
- I can prove it by treating it.
- No, you can't.
I was just with her.
She doesn't want any more treatments,
she doesn't want any more experiments.
She wants to go home and die.
- That's called the principle of autonomy.
Basically that a patient has the right
to refuse treatment at any point
as long as they're competent
and by competent it means
that they're able to understand the consequences
of their actions.
So if they say they wanna go home, and you tell them,
"You can possible die if you go home."
They can say that back to you
and understand what that means, they're free to go home.
- You're being an idiot.
(thunder roaring)
You have a tapeworm in your brain.
It's not pleasant, but if we don't do anything,
you'll be dead by the weekend.
He's right, we should X-Ray her,
but we don't X-Ray her brain,
we X-Ray her leg.
Worms love thigh muscle.
She's got one in her head,
I guarantee you there's one in her leg.
- Um, I did not know this.
This is beyond my expertise
and probably most Doctors' expertise.
- This here is a worm larvae.
- So if it's in my leg, it's in my brain?
- Are you looking for a guarantee?
It's there.
Probably been there six to 10 years.
- How does he know that?
- Carbenzop.
- He's giving her a de-wormer.
- If anyone asks, you have 11 daughters and five sons.
- Aw!
(kids talking)
- Wait that's 16 students.
They said her class has 20.
Where are the other five, why didn't they show up?
Oh wait, 11 and five, sorry the other four.
"We're happy you're not dead."
- I want a hug and a kiss from every single one of you
get up here right now!
- Don't give the kids the worms!
I'm just kidding.
- Doctor House?
You have a patient.
(laughing)
- He says he needs a refill.
- Got change for a dollar?
(laughing)
- That's funny.
Patient got hooked on them tic tacs.
There we have it.
House episode one, season one is in the books.
Medical accuracy?
It's somewhere in the middle range.
These are very rare cases.
Almost never seen in the United States,
like pork tapeworm.
Most of our pork is well cooked so we don't see that.
The way that they go about practicing medicine
is probably the most unrealistic part of it.
House is just a maniac,
treating patients without telling them
what he's treating them for,
breaking into their homes.
Crazy, but also crazy entertaining, so.
I think there's gonna be some very interesting episodes
to review from Doctor House.
If you know any of these specific episodes
that carry a good mystery and a good balance
of medical stuff and drama stuff,
leave it down below in the comments.
If you want me to do a different show,
definitely leave it in the comments.
The more subscribers we get, again,
the better and more content I can continue making.
Subscribe, subscribe, subscribe.
Stay happy and healthy.
(relaxed music)