houserocket, it's James Saxenmeyer.

Well, there's no indication that House was working in PPTH five years before the episode. So it might have been when he and Stacy met Cuddy. Afterwards, Cuddy hired him for being a "good doctor that couldn't get a job in a blood bank" and a little for guilt. The only flaw in this is Wilson. He probably wasn't working on PPTH either, or we'd see him somewhere. So maybe he followed House? It's weird. On the other hand, we do know that they didn't meet at work, so it fits.

I have to say, this episode is on right now which is why I'm going back to it, as a narrative exercise I find this episode amazingly good television but I almost don't like it because really I think what I'm taking away from is that if House amputated his leg, he would have no pain. It really is the pain that controls his life and basically one procedure would end all of that. I mean even the whole Stacy situation, I see a really big grey area as to who was really wrong and who really right in that situation. I mean, what happened to him was horrible but people with horrible back issues (people I hang out with at the diner who are taking 100 back pills a day) they really have no way to heal themselves and all House would have to do would be to cut his leg off. In a way, it almost seems self indulgent and it makes it difficult for me to really respect him. If you have a tooth ache and you don't go to the dentist, should I really feel sorry for you that your tooth hurts? I think the narrative, throughout the show, tells us that we have to respect House's pain and I just don't know if the circumstances warrant that. It isn't chronic, in the sense that one procedure takes all of the pain away. I just don't understand why he couldn't do it. Even if he couldn't do it within the heat of the moment, why couldn't he do it after he had been so beaten down by the pain? Does anyone else have issues with that? I understand that the issue is much more complex than that and involved him being misdiagnosed and his issues with Stacy but the pain could be totally eliminated.

I've never had issues in that way, I have to admit, but that's partly because I've known an amputee who lives with phantom pain. In some ways that seems almost worse than pain in a still-existing limb, because there's less that can be done for phantom pain. Cutting off the leg may not have been the easy answer, in the end.

There are multiple arguments you can make as to right and wrong in this episode. Legally Stacy was House's medical proxy so she had the right to make the call. As a lawyer, she knew that the purpose of a proxy is to ensure the patient's wishes are carried out, but it does not carry a legal obligation to do so. Medically House had been right every step of the way. He had diagnosed himself. He had predicted his heart attack. It was very much in keeping with House's personality as a gambler and with the way he practices medicine that he would opt for the riskiest treatment which, if it were successful, would leave him completely cured. Of course, if it were not successful, it would probably kill him. We'll never know whether the treatment he requested would have succeeded. Morally is where everything is a huge mess. Stacy's motives were good. She wanted to save his life. House's point of view was that he had had three medical issues. First, the blood clot had caused muscle death. The bypass had cleared the clot so there would be no additional muscle death if they waited. Second, the extreme pain was going to kill him. The chemically induced coma took care of that. Third, as a result of restoring the blood flow, "all that crap ges washed back into my system. The cytokines could cause organ failure. The potassium could cause cardiac arrest." At that point, this was the only medical issue left. For me, Stacy loses whatever moral high ground she had because she planned to authorize the surgery before House was in the coma. Had she asked how long it would take before they saw if it were going to work or if she had waited a couple of hours and then authorized it, I could sympathize with her. But, because she signed the second his eyes closed, I feel that what she basically did was put her medical opinion above his. And, while I'm sure that many constitutional attorneys are also expert diagnosticians, I choose to side with House in this disagreement.

Would phantom pain still require huge amounts of pills to control? How many amputees really get phantom pains? I just don't really know. From what I've been able to pull up online, it says that the most common cases where you see phantom pains are people with prior, continued joint and muscle pain. I guess it would depend on how long he was misdiagnosed and if he ever had any other joint issues. Incorrect surgical procedure was another one, and again, I would assume that this, while being a risk, wouldn't be as bad considering that Cuddy was there and was obviously a good doctor. Climatic conditions are kind of a wash, because we don't know. Then there are stress, inactivity, and periodic illnesses. Now, he be more likely to get phantom pain, because he has been living with muscle pain for years but at the time, he might not have experienced as much. It says that drug dependency can also cause phantom pain to increase. Apparently it can happen in 95% of cases according to CNN. Stoppain.org says that the sensations gradually get better. I would still think that it would have to be better than the agony he seems to be in right now, although they do mention Oxycodone to be a drug therapy for the pain, they also mention antiseizure drugs and anti-depressants.

Razor--the other thing you're not considering is the location of the injury. It's pretty high up and amputation would likely have to be very near or at the hip. With an amputation that high up, it is my understanding that prosthesis is much more complicated and less likely to be completely successful in restoring House's quality of life. I'm thinking that entered into his equation as well.

He induced a migraine in Coma Guy (Distractions). Cuddy was able to tell this because of the increased blood flow in his cerebral arteries, not because he was exhibiting symptoms of pain. The severity of comas are measured by how insensitive the patient is to pain. So, while in a coma, even if his leg sent out pain signals, his brain would not register them. And, if the brain doesn't feel it, neither does the person.

Well then that makes sense, and I apologize for my ignorance lol. I figured it was a form of sleeping where the person couldn't be woken up by just shaking them or something. Personally I think Stacy should had waited a day or something, see if things got better, not the second he was in the coma. I guess we'll never know though.

Another thing that has always been a little bit confusing about this episode, and made it somewhat difficult to analyze imho, is asking how much of House's story is actually real? House knew Cuddy, presumably Cuddy was working at the hospital that House first went to. Did House work there as well? If he did, I don't think anyone would have simply assumed that he was a drug addict. Was the first portion of the diagnostic process with the 3 med students merely set up to show how difficult the diagnostic process could be? If Cuddy was his attending, wouldn't she listen to him or was Cuddy just a representation of an attending doctor? It just seems to me like doctors wouldn't just ignore a brilliant diagnostician complaining of pain in his leg. We don't really know that much about House pre-infarction though. Did he have issues with street drugs before the infarction? The problem I see with this is that, not only did the doctors not do anything for three days but House didn't do anything either. House doesn't seem like the kind of guy who would doctor shop for 3 days trying to get pain pills if he was having horrible pain in his leg. Cuddy never struck me as the kind of doctor who would ignore something like that. Wouldn't he have demanded an MRI sooner? I would think he could get one. Personally I think Stacy should had waited a day or something, see if things got better, not the second he was in the coma. I guess we'll never know though. I just don't know the odds on the whole situation. Was it 50/50 that he could die if they did what he wanted? If there was a 100% option that would keep someone I loved alive, I would immediately go there. At the same time, we see from the wreckage of House and Stacy's relationship that you can still lose everything, even if the person you love lives. This was before the whole Terri Schivo case, but I thought that they really didn't do as good of a job as they could have done with the whole Medical Power of Attorney thing. I'm not a lawyer, but it seemed to me like Stacy kind of violated the conceptual basis for it, although she might very well have been following the letter of the law, she seemed to be ignoring the intent. Although, in a way, she admitted that when she was talking to Cuddy before they went ahead and ignored his wished.

so it makes me think that someone in the clinic missed it, then when he came back, he saw a higher-up doctor, who in this case, was Cuddy at the time. Eventually, his original doctors decided to put a catheter up his urethra in order to see if he really was sick or if he was faking it to get pills. It turned out that his urine was 'tea coloured' and they figured out that there was blood and fecal matter in his urine and then, I think that was the point where Cameron comes in and says it was an infarction, then that was when they flashed back to Cuddy apologizing that they missed the early signs. They never actually went into why House himself didn't do anything more drastic about his pain but I think you're explanation is as good as any. It still kind of seems like a stupid thing that House wouldn't do but we've seen throughout the series that House tends to slack as far as his own health is concerned. People use pain pills strictly as a recreational drug, sometimes there is really no reason for them to be using the drug other than just to get high. If he was hooked on pills before he got the infarction, it might have played a role in delaying his diagnosis. I know everybody is hooked on pain pills in this day and age but I don't really know about the 1980s (did we ever get an actual timeline? House said that he treated Esther when his team was wearing 'Frankie Says Relax' tee shirts and that is in the 1980s, so are we assuming the infarction was after that, were they up to White Snake tee shirts at that point?) I don't recall a whole bunch of controversy about scripts until the 90s, I'm not saying that pill abuse didn't exist before that, 'Mommas Little Helper' was written in the '70s, plus House never really struck me as the kind of guy who went with what everyone else was doing at the time. I have to say that if hadn't done acid prior to Distaction then that whole seen was completely insane, and not realistic. I think one of the main problems with handicapping this kind of stuff is that House is a doctor, a really great doctor, so just because he knows how to shoot himself up or he uses acid, you can't really assume that he knows how to do it because he is an experienced user, not just because he's a man of science, etc.