For all those who will be monitoring the fate of Dr. House on Polish television from September again (and maybe only now), the 1st episode of the 5th season will be commented by Dr. Wojciech Feleszko from the Warsaw Medical University.
This fragment of the series is medically plausible, although the intrigue was very confusing. A woman who seemed to be crawling ants was brought to the hospital. She was diagnosed with anemia, low blood pressure, and abdominal pain. At the same time, no one gave her a stomach ultrasound or asked her about her period. These are the primary questions - it would probably have been much earlier that the ectopic pregnancy was discovered much later. Moreover, the woman starts rectal bleeding - and here, according to the principles of the series, she gets a colonoscopy, but again, not a stomach ultrasound! The ultrasound persuades doctors only to take a positive pregnancy test... and still, they only examine the uterus. Nobody thinks of the possibility of ectopic pregnancy, which is not such a rare medical case. American statistics notes a hundred thousand annually, of which the vast majority of cases - a tube pregnancy, and only a small number - abdominal (abdominal). This is only guessed by Dr. House himself. The ultrasound shows a fetus attached to the wall of the intestine.
Let's return to the hallucination that caused the whole thing at the beginning of the series: it is known that the woman travels a lot. One of the first suspects should be tropical (exotic) diseases. However, the diagnostic team rejects this possibility solely on the grounds of lack of fever. Also, no one was interested in changes in the skin on the legs of the patient. They were mistaken for ordinary bruises, even though they did not behave like typical bruises - there was no normal change in the color of the bruises.
And the next problem, repeated in all of Dr. House's episodes, is that the diagnostic team grabbed an idea and did not hesitate to do so; and if they failed, they were looking for another idea. In fact, the situation looks like a lot of research is being done at the same time on complex, difficult patients, which can give them an indication of the direction they are looking for. I would compare it to throwing a wide net: if something gets caught, then the medical board follows this path.
After the ectopic pregnancy operation, the patient continues to have very low blood pressure, plus additional neurological symptoms such as too frequent blinking. A female doctor decides that multiple sclerosis is an autoimmune disease. She is going to give interferon, but the patient suddenly has a fever. So, it is an infection. The team believes that during the operation something was missed. In the video recording the operation, doctors notice something on the intestines that is mistaken for ganglioma. It needs to be cut out. And here comes the absolute fiction: no one performs such a painful operation without anesthesia! If the patient had been so unstable after the operation that it would have been impossible to prescribe general anesthesia, the operation would have been performed under local or subarachnoid anesthesia. The operation "live" does not look convincing. In addition, it is performed by doctors who have no experience in cancer surgery. This is where the fantasy of the writers got far away.
The carved education is not a ganglioma. Maybe it's amyloidosis? - doctors are throwing doctors' brains out. Or cancer? On the computer screen, they show the image of education to the oncologist, Dr. Wilson, who decides it is lymphoma. In fact, this kind of tissue would be considered by a histopathologist, a doctor with extensive experience in detecting such changes. The patient would not have been prescribed chemotherapy based on "I think" one oncologist.
The final diagnosis is made by Dr. House: this is "beautiful leprosy". The bruises on her legs turn out to be microbial damage, and the doctor explains to the patient that she looks young because it is this kind of leprosy. However, it seems that she has one type of disease on her legs and another on her face. A woman's beautiful skin could be explained by the stage of the disease, as in the early stages the skin may be smooth and shiny, but in this case, it would be both on her legs and face. In addition, the disease is mainly manifested in the loss of sensitivity, especially in the toes and toes. However, this woman has nothing like that. On the other hand, we have the hallucinations that started it all, and this is an exceptionally rare manifestation of leprosy. But is it incredible? Well, medicine is an inaccurate science, and atypical manifestations of even typical diseases often surprise doctors. As my teachers used to say:
In medicine, like in the cinema, everything is possible!
Lupus lupus
What's the most common phrase that Dr. House's team says during the diagnosis? Regular viewers will have no doubts: "It could be lupus!" The creators of the series refer to it in different situations and jokes (for example, in the 1 series of 4 seasons, when House helps to diagnose a casual janitor. He says the sacramental "Or it's lupus", explaining that his grandmother had lupus). What is this? Lupus is one of the most mysterious diseases of the immune system. Unexpectedly, for unknown reasons, the human body begins to struggle with its tissues. Lupus is sick with 40-50 out of 100 thousand people. Much more often women get sick. That's probably why in one of the series, where someone finally fell ill with lupus (4x8), this patient is a man.