It’s never Lupus – the science of House MD

There’s a cold that has been going around for the past few weeks and it has been bugging me hard for the last few days. I have also just been watching House MD at a rate of about an episode a day, so naturally all my symptoms could also have been deadly. Patient presented with sore throat, sinus pain, sneezing, coughing, pressure on eyes and ears. It could be lupus, if you believe the show.

A quick catch up for people who have never seen House: every episode, a patient comes to this hospital with a mysterious disease. Dr House and his team think it’s Scary Disease A (or lupus), but when they start treatment the patient gets worse and probably has Scary Disease B, as deduced from an illegal break-in into the person’s home by House’s staff. Unfortunately, the treatment for Scary Disease B is deadly if it turns out that it’s not Scary Disease B after all. In the last five minutes of the show the patient is hanging on for dear life when House suddenly realizes it’s actually Slightly Less Scary Disease C after all, and treatment is very simple and safe. Also, Dr. House hates people, rarely looks at his patients, limps, and is addicted to Vicodin.
You’re all caught up; I can continue.

House has some doctors working for him, but these people do everything: they don’t just treat the patient, they also break into their homes and do all the lab work. Why they didn’t write in even one lab tech is the biggest mystery of the show to me. Doctors don’t run gels! (Although it would explain waiting times…) In one episode House suspects that a patient’s medicine had been switched my mistake in the pharmacy. Even though his motto is “everybody lies”, he sends someone down there to talk to the pharmacist instead of being sure and testing the residue in the pill bottle against the pills he thought it was (they were the crumbly kind of pills – not gel caps). Oh yeah, right, no properly trained lab techs available…
An older article about House on LabLit pretty much says the same thing.

But the mystery diseases that come by every week, ridiculous as they may be, are actually based on real cases. Last year Andrew Holtz wrote a book about “The Medical Science of House MD” and was able to track down a lot of the cases mentioned on the show. But as some commenters on the YouTube video (below) point out, the writers base the stories on actual reported cases, so this might not come as a huge surprise.

I guess some viewers might not care so much about whether or not cases could be real or not, but fans of accurate medical science on TV might like to see the references without having to redo all the research themselves. But I haven’t actually read the book, and people who have have mixed reactions.

You should also have a look at House medical reviews, a website by a doctor in Illinois that reviews every episode of House MD from a medical perspective and rates the quality of the diagnoses.

But now for some useful science/House-related trivia: Hugh Laurie, who portrays House so well that my brain has a hard time accepting that he’s the same guy who did hilarious nonsense like this, is himself a huge fan of western science. He’s said: “I grew up with an impatience with the anti-scientific. (…) So I’m a bit miffed with our current love affair with all things Eastern. If I sneeze on the set, 40 people hand me echinacea. But I’d no sooner take that than eat a pencil.”
(The rest of that interview is terrible, but it was the only one with the science quote. Just trust my quoting and don’t read the rest. I tried reading the whole thing but stopped at “previously unknown” and decided the interviewer was an idiot.)

This post, by the way, was just to justify my current addictions with House MD and YouTube. I’m very open about my addictions. Learned that from the show, too.

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