4.16 Wilson’s Heart Initial Symptoms: Woman with traffic accident injuries + elevated heart rate Diagnosis: Amantadine poisoning (House) + influenza (Taub) Contributions by Team House (5): Idea to search apartment for toxins, idea for deep brain stimulation to retrieve memory, notices influenza rash, diagnosis for amantadine poisoning, knows that dialysis won’t clear drug from blood Cameron (N/A): Not in episode Chase (1): Sees jaundice Foreman (0): None Kutner (1): Stops Thirteen from connecting wrong tube on patient Taub (1): Suggests a toxin (lead, drugs) is causing heart trouble, diagnosis for influenza Thirteen (0): None Notes: This was a very hard episode to assign points for. I stuck to my method of working backwards from the correct diagnosis, which meant discarding a lot of things that would otherwise have counted for points or errors. The telling point here is that nothing would have saved the patient (Amber Volakis), so everything they did to her that could have potentially harmed her was irrelevant. I’m also calling influenza a separate diagnosis, although it didn’t cause her fatal condition that they were diagnosing, because 1) it did cause at least one symptom and 2) knowing that she had the flu may have led them deduce that she had taken drugs for it and led them to the amantadine poisoning diagnosis without House’s memory of seeing her taking the pills. Wilson persuaded House to induce hypothermia and put Amber on bypass to avoid sending chemicals from her damaged heart to her brain. Everyone but House and Wilson acts as if this was a bad idea, so I’ll assume it was. Again it didn’t matter in the end, so no points were awarded or subtracted for it. House and Foreman wanted to treat Amber for Rocky Mountain Spotted Fever before confirming the diagnosis, but Wilson prevented them from doing so. Foreman acts as if this is bad medicine, but it makes sense to me. On Foreman’s suggestion he and Cuddy later warm Amber up, but as Wilson feared the chemicals produced from her damaged heart do affect her brain. If Wilson hadn’t stopped them then perhaps she would have suffered brain damage. For this reason I’m awarding Foreman an error for it, even if technically it would have been inducing brain damage in a dead woman. I mean, we wouldn’t have had the touching farewell scenes if Amber was brain damaged, would we? Taub suggested “infection” but her influenza was not what caused her symptoms, so no points were awarded. Taub does get credit for a diagnosis for declaring her rash a symptom of influenza, however, as House later remembered that she did indeed have it. I’m assuming that the flu pills which killed Amber was not in her apartment to find, that the only ones she had were on her and lost in the bus crash, so Kutner and Thirteen lose no points for not finding them in the apartment. I’m still awarding House a point for suggesting they search there, however. Thirteen almost connected a wrong tube on the patient, but Kutner stopped her. Thirteen doesn’t lose a point because she didn’t actually hurt the patient, but I’m giving Kutner a point. House asks everyone what the significance of sherry could be in his dream, and Kutner suggests it may stand for Sharrie’s Bar. I considered awarding a point to Kutner but didn’t, as the information gained didn’t really advance the case and it wasn’t exactly a medical suggestion anyway. House has an idea to regain his memory by using deep brain stimulation. Cuddy rejects this by saying it’s too dangerous, but Wilson later persuades him to do it. It’s through the procedure that House remembers Amber taking amandatine and makes the diagnosis. Cuddy, however, turns out to be right about the procedure being dangerous.

For seasons 1 through 3, the tally of diagnoses + clues/innovations - errors is: House 202 Chase 57 Cameron 42 Foreman 42 This tally will no doubt be revised more than once, as the reviews of three episodes are incomplete, but for now the total for season 4 is House: 16 diagnoses + 33 clues - 1 error = 48 Kutner: 4 diagnoses + 10 clues - 1 error = 13 Thirteen: 2 diagnoses + 11 clues - 1 error = 12 Foreman: 1 diagnoses + 11 clues - 1 error = 11 Taub: 3 diagnoses + 6 clues = 9 They're all very close together but somehow Kutner comes out on top, despite how dangerous he is with those defibrillator paddles. The difference is so small that I'd call them equal, though. And for what it's worth Chase: 2 diagnoses + 3 clues = 5 Cameron: 2 clues - 1 error = 1 There were 98 patients treated and 84 saved for the entire series to date for an 85% success rate (this includes the two House diagnosed himself in 'Airborne' and 'Whatever It Takes' and the patient Foreman diagnosed himself in '97 Seconds').

In addition to thanking Taiga for doing this, I want to go on record for how much I hate it that House didn't get a diagnosis for 5 out of the 16 episodes this season. No points were awarded for 3 Stories, No Reason or One Day, One Room. Other than that: In season 1 he got a diagnosis point for all 21 analyzed episode (100%). In season 2 he missed Safe, but got the other 22 analyzed episodes (95%). In season 3 (amid the Tritter angst) he still got 16 and missed 7 (Informed Consent, Finding Judas, Half-Wit, Airborne, House Training, Family and The Jerk) (70%). In season 4 he got 11 and missed 5 (69%). If House isn't a genius, what's the point? ~~~ Chase should get another contribution point for Lines in the Sand. When they were first doing the DDX on the move (on the way to the clinic, Chase says "Could also be an environmental reaction. An allergy. Dust, wheat, pollen, a toxin or something he ate." But the last four words are missing from the transcript and the final diagnosis was something Adam ate. Edited to shove my two posts together because double posting is a bad thing.

By my system, credit goes to the first person who suggests the diagnosis. That was Cameron with the tick paralysis diagnosis in 'Safe'. The idea is that Cameron put that idea in House's mind, and his big dramatic moment was realizing that she was right and proving it. It happens all the time on the show. Thanks for the correction on LinS, I'll give Chase a credit. The boy's illness was caused by a parasite in what he ate, not what he ate per se, but the kid's pica is what made him sick so Chase gets a point. I'm not so worried about House getting less diagnoses in the latter two seasons (though I wish he'd start acting more like the brilliant doctor, as you say, and stop trying to remove or irradiate healthy organs before running simple lab tests). He's still a genius, but he's also a teacher. The ducklings were supposed to be improving as diagnosticians, and in S4 he was standing back more to let his contestants show their stuff.

Cameron wasn't even there at the end, so we'll never know if she would have pursued the diagnosis or not. I appreciate what you're saying but stand by how I analyzed that episode: tick paralysis was Cameron's idea, House realized it was right. He got a point for finding the tick but not for Cameron's idea.

Remember me? I've been slacking off but I'm going to catch up. However, no one has been writing transcripts this season so all I have to work with is the official recaps and the medical reviews from Polite Dissent. I don't tape/TiVO/download the episodes and no one has ever accused me of having a photographic memory , so I'll need help here. My system is that I work backwards from the correct diagnosis, so even if someone makes a brilliant deduction to realize the patient is lying or comes up with a brilliant way to test a theory, it doesn't count if it doesn't lead to the correct diagnosis. 5.07 The Itch Initial Symptoms: Man with agoraphobia + headache + seizures Diagnosis: Lead poisoning from bullets left inside patient after a shooting (House) Contributions by Team House (2): Realizes patient’s bowel is obstructed, diagnosis for lead poisoning Cameron (2): Persuades patient to allow team to keep treating him, observes flattened villi in bowel Chase (0): None Foreman (1): Idea to perform EEG to diagnose cause of seizures Kutner (0): None Taub (0): None Thirteen (0): None Notes: The team was limited while diagnosing and treating this patient, as he refused to leave his home. Removing the bullet fragments without anesthesia was brutal even by House’s own standards. I’m assuming the partial bowel obstruction was also caused by the lead poisoning. House spent a lot of the episode trying to force the patient to go to the hospital against his wishes. I’m calling this a value judgment and therefore am not awarding or deducting points around this issue. Taub loses a point for igniting the patient’s intestinal gas during the surgery, but that may be excusable given the circumstances under which he performed the surgery. 5.08 Emancipation Foreman diagnosed a clinic patient with help from Chase and Cameron, so I'm calling that Case B. Case A Initial Symptoms: Girl with pulmonary edema Diagnosis: Arsenic poisoning (House) + acute promyelocytic leukemia (APL) (Thirteen) Contributions by Team House (2): Diagnosis for arsenic poisoning, gets patient to admit truth and contact her family Cameron (N/A): Not part of diagnosis Chase (N/A): Not part of diagnosis Foreman (1): Notices blood in patient’s urine Kutner (1): Observes on fMRI that patient is lying about her family Taub (0): None Thirteen (1): Diagnosis for APL Notes: I don't recall but I'm assuming that the arsenic in her system was making her sick too, or that it would have if she hadn't had APL as well. From the patient’s fMRI Kutner deduces that the patient is lying about her parents, and House later figures out that she’s lying from guilt and persuades her to contact her family. Because the patient is a minor and (according to the show) would need a bone marrow transplant to save her life, I’m awarding points for this. Case B Initial Symptoms: Boy with lethargy + diarrhea + bloody vomiting Diagnosis: Iron toxicity from too many vitamins (Foreman) Contributions by Team House (N/A): Refuses to participate in diagnosis Cameron (0): None Chase (1): Suggests patient is being poisoned by his mother or brother Foreman (1): Diagnosis for iron toxicity Kutner (N/A): Not part of diagnosis Taub (N/A): Not part of diagnosis Thirteen (N/A): Not part of diagnosis Notes: Who didn't call it that the brother poisoned the patient? 5.09 Last Resort Initial Symptoms: Man with lack of breath + fatigue + headaches + stomach aches + skin rashes + heart palpitations + insomnia Diagnosis: Melioidosis (Cameron) Contributions by Team House (4): Observes patient has low lung volume, diagnoses seventh-nerve palsy, observes patient is sweating on just one side of his face, diagnoses patient with low calcium (Chvostek's sign) Cameron (2): Suggests patient’s medications have been protecting his kidneys, diagnosis for melioidosis Chase (N/A): Refuses to participate Foreman (1): Suggests chronic lung infection Kutner (0): None Taub (0): None Thirteen (2): Observes patient has high heart rate, suggests chemical cardioversion to restore heart rate Notes: Diagnosis was complicated by the patient, you know, holding House and Thirteen hostage. The medicine was confusing. If the writers can’t keep it straight, don’t expect me to; I’m just doing the best I can. Since chronis melioidosis can affect the brain, I’m assuming here that the patient’s palsy and anhidrosis (sweating on one side of his face) were symptoms.