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March 13, 2010

How good a doctor is House, anyway?

image from House

One of my all-time best ego feeds happened a few years ago, when I successfully identified the mystery disease on House before Dr. House and his team did(*).

Much of each episode of House deals with the art and science of medical diagnosis. But how realistic is the medical detective work on the show?

Enter Scott Morrison, M.D. Morrison has a family practice in Illinois and a blog called Polite Dissent, where among other things he picks apart each episode of House, explaining what's realistic and what's nonsense. Some typical observations:

I'm suspicious of Thirteen's "bubble test." While there is a bubble test that can be used to find heart defects, it is only used on a relatively small single organ. Thirteen's idea of trying to track microscopic bubbles wherever they may go over the entire body seems fruitless, especially when the overlying gastrointestinal tract is likely to have gas bubbles of its own. Plus this would only work if the cysts were connected.

It's fractures of the long bones (femur, most commonly) that lead to fat emboli. I don't think there's enough fat in a toe bone to cause a fat embolism.

Sequencing the cardiac sodium channel, in a hospital lab, in a day. Right. See me about that property in Arizona. Even with modern equipment, gene sequencing is tricky, time consuming, and a specialized skill.

(*)Leprosy FTW! But then just a few weeks later I missed the diagnosis of xeroderma pigmentosum, even though I had just worked on a documentary about it.


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Posted by Chris Spurgeon at March 13, 2010 07:23 PM