2.13 Skin Deep

2.13 Skin Deep
From tv.com: House uncovers a startling secret when he treats a teenage supermodel for heroin addiction. Meanwhile, Wilson hopes the increased leg pain in House's leg is an indication his leg nerves are regenerating.

'House, this is God' I love that scene so much.

Me too. Still can't believe Wilson missed 2 testicles on an MRI.

Still can't believe Wilson missed 2 testicles on an MRI. For a second there I thought you meant House's.

I donj't think there's any way Wilson would miss House's.</hoyay>

The best moment was when the POTW said to Cameron "You haven't taken a run at your boss", and instead of denying it, Cameron changes the subject. Cameron's life is devoted to taking runs at House, and other coworkers.

His DNA says you’re wrong. Frogs and snails and puppy dog tails. You’ve got male pseudohermaphroditism. See we all start out as girls and then we’re differentiated based on our genes. The ovaries develop into testes and drop. But in about 1 in 150,000 pregnancies a fetus with an XY chromosome, a boy, develops into something else. Like you. Your testes never descended because you’re immune to testosterone. You’re pure estrogen, which is why you get heightened female characteristics; clear skin, great breasts. The ultimate woman is a man. Nature’s cruel, huh? Apparently House got it wrong. What Alex had was androgen insensitivity syndrome.

Wilson did not miss anything because he did not do and MRI as House explained to Cameron when THEY finally did the MRI. The only way the writers found to make House and only House get the diagnosis was to make sure nobody else could. So, Cameron and Chase don't do the MRI (Alex is trembling), if they had THEY would have seen them. Then Wilson uses an ultrasound (which House says is the right choice for what he was looking for i.e. ovarian cancer, Wilson does notice under developed ovaries). Another blot on the writers' side is that both Wilson and Cameron (who does a pelvic) do not comment on the fact that Alex probably did not have a uterus. This was the episode that taught me not to take House's medicine seriously. People screw up only when we are told/shown they did, otherwise it's usually poor research/dramatic license on the writer's part.

This was the episode that taught me not to take House's medicine seriously. People screw up only when we are told/shown they did, otherwise it's usually poor research/dramatic license on the writer's part. House's medicine shouldn't be taken seriously because this is a television drama, not a true-to-life documentary. Everything is manipulated to make the plot more dramatic. They're usually generally right, and every now and again, they will get it exactly right, but ultimately what they're doing is trying to fill 40-some odd minutes.

Perhaps I should explain myself better, 3 years later people still believe Wilson missed the testicles in an MRI, even though we are told in the episode that he did not do one. People still say that both Wilson and Cameron did not notice there was no uterus, therefore both of them are hacks. Nobody during the episode mentions the lack of uterus, but fans read about the illness and conclude Wilson&Cameron=hacks. My point is, if they don't tell/show in the episode then it did not happen, regardless of what would happen in the real world. This episode brought that home.

I agree with you, ixtab, that Wilson is not an idiot. But in the episode, he did check the patient's entire body for cancer, and I'm pretty sure it was with an MRI. That is implied during the conversation between House and Wilson, when they are looking at MRI scans: House: It’s gotta be cancer. Wilson: It’s not cancer. You seem to be back to your old miserable self. House: So I just randomly predicted she’d respond to IVIG? Her twitches are gone, her memory’s getting better. Wilson: What did you take? House: If the increased pain’s psychological, no drug’s gonna help. Wilson: If you thing it’ll help, the drugs will help. Power of the mind. House: You’re right. The more I talk to you, the more the pain floods back. (He looks at a scan.) Knew the twins were real. Chase owes me. You check the pancreas? Wilson: Oh come on, you’re just making up organs now, aren’t you? We checked the pancreas. Obviously, you’ve taken something. House: You check the bones? There are a lot if bones, I think. Wilson: And none of them have cancer. House: Ovaries? Wilson: There’s no mass; if anything, they’re undersized. No leukemia. No Hodgkin’s. We checked everything. Unless they’ve invented a new organ, it’s not cancer. Maybe those weren't MRI scans; maybe they were some other kind of scan. But Wilson did check the entire body. Wilson saw testicles but assumed they were undersized ovaries, because his patient was a female, and he had no reason to believe that she wasn't a female. It (understandably) never occurred to him that she might be a he. So to me, because Wilson did check the entire body, it is odd that there was no mention of a uterus in these scans or in this conversation he had with House. But I don't mind, because it was an interesting story nonetheless. I usually prefer when the medicine is accurate, but ultimately it doesn't really matter to me. It's fiction, and they're telling me an interesting story so I can learn more about House.

What I find very telling about that little bit of dialogue was how much invested in House’s behaviour Wilson was: House: It’s gotta be cancer. Wilson: It’s not cancer. You seem to be back to your old miserable self. House: So I just randomly predicted she’d respond to IVIG? Her twitches are gone, her memory’s getting better. Wilson: What did you take? House: If the increased pain’s psychological, no drug’s gonna help. Wilson: If you thing it’ll help, the drugs will help. Power of the mind. House: You’re right. The more I talk to you, the more the pain floods back. (He looks at a scan.) Knew the twins were real. Chase owes me. You check the pancreas? Wilson: Oh come on, you’re just making up organs now, aren’t you? We checked the pancreas. Obviously, you’ve taken something. House: You check the bones? There are a lot if bones, I think. Wilson: And none of them have cancer. House: Ovaries? Wilson: There’s no mass; if anything, they’re undersized. No leukemia. No Hodgkin’s. We checked everything. Unless they’ve invented a new organ, it’s not cancer. The case and the tests (MRI scans, or whatever) are almost afterthoughts for Wilson, maybe that’s why he missed the obvious clues…

Everyone missed the clues. And I don't think they were that obvious. He/her didn't have a very common condition, even though House says it happens to every one in 150.000. Sounds much more common than I'd think. Maybe they got the figures wrong. On a side note, this is a great episode. House's at his sardonic best, we have a moving bit about House's pain, a strong Cuddy and Ryan Adams in the BG.

Cameron: Wilson already did an ultrasound, said her ovaries were undersized. House: The ultrasound would be the way to go if you were looking for ovarian cancer. Cameron: What are we looking for? (The machine beeps.) House: That. Cameron: Oh my God. House: Looks like a tumor doesn’t it? Cameron: But those are. House: Yep. Last post, no point beating a dead horse. The testicles did not look like ovaries they looked like a tumor. Nobody mentions a lack of Uterus, not even as they do the MRI, one would think not seeing a uterus might be a bigger clue. SO if Wilson or Cameron or Chase had done an MRI,, they would have seen the "tumor". When House schedules the MRI nobody says "Wilson already did one", but Cameron does say "Wilson did an ultrasound" Why I keep harping on this ? Because most of the time this episode is the proof that Wilson is the worst oncologist ever!! Every time there's a discussion about Wilson's professional worth this is brought up.

Wilson missed the cancer because he wasn't looking for testicular cancer. He had the wrong shoes. The only thing he (and the rest) missed was the undersized ovaries. I can't believe people actually use this episode to bash Wilson when they have the Tritter arc.

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