House M.D.

Pre-Med & Medical School Careers in Medicine
21

<p>Every physician is making diagnoses all the time. It's part of the routine of an exam. Take the history, start formulating a differential diagnosis, perform a physical exam, narrow down the ddx (that's an abbreviation for the differential), order lab tests if needed, make final diagnosis. Come up with plan - write a script, refer to specialist, do some sort of procedure.</p>

<p>According to the Fox website, House is a specialist in infectious diesease.</p>

<p>There is a specialty called diagnostic radiology (as compared to interventional radiology)</p>

22

<p>I missed that infectious disease part, that sort of vile stuff interests me</p>

<p>btw bigredmed watch more of the episodes, some of them are outrageous, but others seem very plausible</p>

23

<p>House's specialty in terms of his fellowship and training is in ID. But his department at the fictional Princeton Plainsboro Teaching Hospital is the department of Diagnostic Medicine, which is not a real specialty. I believe this is discussed in episode 1.18, when the benefactor of the hospital is trying to have House fired, but I might have the episode number wrong.</p>

<p>Fans of the show are well-versed in the fact that House does not only deal in ID, and that his "team" includes an endocrinologist as well as two others (whose trainings escape me at the moment; I believe exactly one of them is ID).</p>

24

<p>One is ID, other is a neurologist.</p>

25

<p>I think house is an awesome show, but try watching Trauma: Life in the ER on Discovery Health. At least this is a real life show, and you acutally get to witness more surgery, etc., more than just Cuddy standing in the viewing room above watching the surgery.</p>

26

<p>I agree, if you're interested in medicine, check out the Discovery Health channel, they have a lot of interesting programs....</p>

27

<p>I think it shows the importance of details--details that the patients often leave out because <em>they</em> don't think it's relevant to their illness, or because they think/hope the doctors have the means to diagnose them independently of context.</p>

<p>As for how realistic everything else is, I dunno. lol</p>

28

<p>While it might not be a board speciality, there is such a thing as a diagnostician. I had to go to one once last year when no one could figure out what I had -- there is actually a whole department of the hospital (they have 15-20 MDs) devoted to it. That said, it was nothing like House. It was more like a regular doctor's visit than anything else, except the guy spent about 2 hours talking to me and he actually managed a correct diagnosis.</p>

29

<p>No physician could ever act the way House does and survive in a university setting. The whole thing is absurd. I know it's just TV but from a physician's standpoint it's really bad TV.</p>

30

<p>This will show you how realistic house is:</p>

<p><a href="http://www.youtube.com/watch?v=EwIbz9SEzRI&search=mad%20house%5B/url%5D"&gt;http://www.youtube.com/watch?v=EwIbz9SEzRI&search=mad%20house&lt;/a&gt;&lt;/p>

31

<p>Mad TV makes everything in our lives look retarded.</p>

32

<p>I find the show entertaining for mostly non medical-related reasons (I enjoy listening to witty, sarcastic curmudgeons gripe about the world).</p>

<p>Sadly, my experience has been that the medical profession is so overwhelmed with patients, so stymied by health care costs and insurance company bureacracy, that it's near impossible for today's physicians to provide more than average health care.</p>

<p>Now that I'm in my 30's, I've unfortunately had to experience this first-hand when I had my first really major health "event" last year. I've endured more than a year's worth of symptoms with no diagnosis. Doctors nowadays don't have the time to deal with the kind of issues you see depicted on a show like House. If they did, they'd be more inclined to tell you it's "all in your head" than spend the time to get to the true cause of the health problem.</p>

<p>Today's philosophy in medicine is "treat the symptoms" and then get the patient back out the door instead of finding and treating the cause.</p>

33

<p>Assuming that you do not yet know the disease that you have, get a job with really good health benefits and then go to the Mayo clinic or the like. There are just a few places that still put a premium on being a good diagnostician.</p>

34

<p>My dad, who is a senior anesthesiologist (graduated from UPenn Med School), absolutely despises House M.D. and Grey's not because of the entertaining content but because of the way the shows portray anesthesiologists. Most of the time they are shown just giving the GA and then leaving the operating room entirely, their work having been completed. This cannot be farther than the truth. Anesthesiologists most important job is making sure the the right dosages are being used, and are admininstered properly in the right places, and also to make sure that the airways are ventilated properly. Overdoses and incorrect anesthesia treatments can be fatal, and if a patient isnt properly ventilated and monitored during the entire operation the chances of a lethal mishap occuring goes through the roof. They ALWAYS stay next to the surgeon during the entire operation. After you go through surgery, just keep in mind that more than ever, anesthesiologists make sure that you STAY ALIVE during the entire operation.</p>

35

<p>House is actually very accurate. Departments of Diagnostic Medicine are usually staffed by Internists, such as House. However, House did one (two, better, actually), and got his Infectious Diseases residency AND his Nephrology (kidney) residency.</p>

<p>As for the medicine, it's generally quite accurate as well, they don't make any glaring ommisions or mess with medicine enough that people would notice (for instance, they'd forgot to do a test at the beginning that's routine, but they'd do it later).</p>

<p>Edit: And Tokyo, you're right. However anaestisiologists (sorry, I learned the British spelling first, force of habit) are either usually present during the operations along with everyone who's supposed to be there, or it's just House/his team there, so not just the anaestisiologists are ignored, but the OR techs and everyone who is supposed to be present during a standard operation. If you want to see an episode where they honoured everyone, watch "Autopsy" (2x02).</p>

36

<p>I disagree strongly with DMac.</p>

<p>1.) At the point where even the show is referencing the fact that his department is totally unique (see the story arc where the hospital's benefactor wanted House fired, late in season 1), I think it's reasonably safe to conclude that departments of "diagnostic medicine" are not common. This is not to say that there are no diagnosticians - in fact, all doctors are diagnosticians, and some specialize more thoroughly than others and build referrals. But I am inferring from:
(a) I've never heard of such a thing
(b) The show considers it very strange/unique
that such departments are very rare.</p>

<p>2.) Actually, I've found that at least the ID in House is... well, awful. The critters in question are very rarely pathogenic (cryptococcus, for example), and would almost never cause the symptoms in question or be acquired in the manner in question. (In one recent episode where Foreman was the patient, the final "bug" he acquired would usually be acquired by swimming in infected waters, not a brief sprinkler system.)</p>

<p>3.) House's behavior (spitting on a surgeon to forestall a surgery, for example) would quickly have him fired, no matter how "brilliant" he was. These things would simply not be tolerated.</p>

<p>4.) Basic tests are often omitted to make things more dramatic - i.e. omitting complete heavy metal testing when House believed firmly in heavy metal poisoning.</p>

<p>5.) Procedures are often performed by House's team, which would be absurd - i.e. Chase (an endocrinologist? ID?) has been seen performing cardiac catheterization at least twice (citation unknown because my memory is simply not that good).</p>

<p>Now, I love the show. I have never once missed an episode. But as best as I can tell, it is a horribly unrealistic portrayal of medicine.</p>

37

<p>Once again Mike is 100% correct.</p>

38

<p>PRiSM92289 , </p>

<p>Allow me to disect your series of posts. For one, I am an avid fan of the show; it interests me greatly (as I am currently training in Med school). You claim you can relate yourself to House's character, but after reading your posts you are about as far from House as Foreman is to a white guy. </p>

<p>You talk about wanting to be an aspiring 'diagnostician' do you? You also say that you wish you could have more basket cases. You also say you tailed a real MD, and it was boring. Well, it seems to me as though your living in a fantasy world. Welcome to the world of medicine. House is a tv show, it is exagerrated for the sole purpose of being entertaining. They dont show you the hour long tests, or the boring parts where they sit around writing and thinking. </p>

<p>Half the stuff House does would have him fired immediately. I am alot like House (and i can say that because im in Med school, and by the writing in my post, and my name, im sure you get the point). But what you're looking for in Medicine is for the purpose of entertainment. </p>

<p>IF you want to be entertained, then go to Hollywood and star in your own doctor series. It's worthless human beings like you that make this planet so terrible. If you want to be a doctor, then by all means, go to med school....but don't try and specialize in whatever field House specializes in, specialize in what YOU want to specialize. </p>

<p>Circumlocution aside.....You are not House, House is not real, House cannot happen, House will not happen, You can't ever be House, You never will be House, House can never be, therefore House does not exist in the same universe as you or I, therefore, speaking of him is inconsequential, and existentialism is in fact being reborn....whoops, circumlocution....</p>

39

<p>cynicalbastard, this is a message board. the people here--including myself--like to talk about random stuff because it's fun. If you have a problem with that, why are you here? If you're going to post again, I hope you'll adopt the constructive tone that sakky and Bigredmed have...I hope your goal wasn't just to be condescending.</p>

<p>On a different note, I think this thread is interesting because often the only exposure the lay public has to medicine, outside of doctor's visits, is on television dramas--ie Gray's Anatomy, Scrubs, ER, and House--thus, discussing how realistic the show is or isn't helps people get rid of their misconceptions.</p>

40

<p>Hmm....Sakky and Bigredmed...? Well, you might as well be making up random names because I have no idea who those two are. Here, i'll even join in on the fun! I joined to be like Joejimblejoppletopplepopple and harryvarryscarrylarrydarrycarry..</p>

<p>Condescending? Well shame on me, I didn't realize I came off that way at all, oh wait....yes, I think I might have...no wait....Nope, Yeah I did. </p>

<p>BillyBobby, PRiSM92289 is a fan of the show House and he claims he's alot like House (to which I can't help but laugh at!). So then he would be used to sarcasm and remarks of the sort, in fact, he would appreciate them for that they are. I'm here to clear up the misconceptions of the medical world, as I am the next medical maverick on the verge. </p>

<p>My posts will be helpful, sometimes, they are not always posted in the nicest way, but what can I say...we are who we are. I'm blunt, I tell the truth, I tell whats on my mind. Some people like it, some don't.</p>