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Bipolar on "House"


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Finally, bipolar disorder on "House"!

"House" is a can-you-top-this? show about a misanthropic diagnostician and his colleagues at a Princeton hospital.  In last night's episode, a famous journalist keeled over at a party and woke up aphasic/agraphic.  Turns out he had cerebral malaria, contracted when he went to Brazil to get experimental brain surgery, in hopes of concealing his bipolar disorder from his fiancee. 

The patient's way of confessing this was to shout "They took my stain! [brain] I couldn't tackle the [bipolar] bear!" Oh, and his neurologist had previously broken into his house, found Topamax among the sleeping pills and amphetamines, and concluded it was merely a weight loss aid.

Nevertheless, I love this depiction of BP disorder on television because:

1.  the guy is depicted as basically sane -- many books published, happy marriage (before the lying is discovered), good friends at work, witty and graceful speech before the aphasia.  The evidence they cite to show that his condition isn't well controlled is an unfinished cabinet-building project left in his kitchen, instead of, say, a shot-up convenience store.

2.  the disorder isn't presented as either the shocking first symptom or the final revelation over which everyone is supposed to freak out; it's just a plot device.

3.  the signs and symptoms of BP presented by the doctors were accurate without  being stereotypical.

4. the show raises issues of trust and disclosure, especially in intimate relationships, which I had just been discussing with Mr. Squirly, minutes before the show aired, and which I continue to think are more nuanced than the therapy books admit.

Or, maybe I just feel special whenever someone says "bipolar" on television.  Sad but plausible.

Did any of you guys see it?

sg

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didn't see it but i totally perk up when i hear about media portrayals of bipolar. most of the public really don't know what bp's about. I love finding out what others think of us. Sounds like we were thoughtfully handled in that episode. nice!

7

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Heya,

Yeah, I really liked that episode.

I had the same reaction to the Topamax scene -- yay!  Bipolar!

There was also a clue earlier in the show, when House was being taken to task by the Medicaid guy for off-label drug use.

This was a good and interesting portrayal of BP and its effects on a high-functioning person, the adventure-seeking, self-medicating and reaching for solutions (he got the malaria when he went somewhere for experimental brain surgery).

Plus I just really lke the show.

;)

--ncc--

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I <3 House.

But am I the only sick fuck that was cracking jokes when they found the topamax?

"His dose is too high!?!?"

"You haven't hit the 'Sweet Spot' yet!"

I'm sick.  I couldn't help myself.  I need help.

But you're all right, excellent episode.  I love that show.

Maddy.

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Heya,

No, Maddy, you're not the only one.

Heehee.  Topamax?  Is fluent aphasia on the PI for that?

Of course I also couldn't resist yelling at the doctors to get a freaking MRI and LP and to just *look at the damn blood* in the microscope, which we learn in freaking first year.  Those guys need a med student to kick around.

Watching medical shows is fun.  I feel so superior ;)

--ncc--

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Oh damn, now you've ruined it for me!!  I tape House so I'm not chained to my TV during the week and now you've told me the plot.  Ruined!!

Seriously, though, I love House, though not for its accurate portrayal of medical treatment.  Even though the wit on the show is wry and biting, the wholistic portrayals of patients and their problems is refreshing.  But even so, it drives me nuts that every patient gets a team of four or five specialists and an infamous diagnostician who order the most expensive test available and the most bizarre experimental treatment at the first sign of difficulty treating a disease.  Come on.  And then each patient turns out to have some weird problem (did you see the tapeworm in the brain one?) instead of the flu.

I've seen a couple of examples of TV dramas recently that portray mental illness quite accurately and use it to drive plot instead of to write off a character.  Some are quite nuanced.  I do think MI issues are getting more fair treatment.  The New Yorker (not the NY Times) recently had a very interesting article about BP treatment.  Maybe the culture is starting to change, despite the Jerry Springer approach of some papers and popular culture.

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Heya,

What makes me yell at the TV all the time is when the specialists do *all their own tests* and never call in a lab tech, surgeon, radiologist, respiratory therapist, nurse, anaesthesiologist, gynecologist, neurosurgeon ...

In real life???  No neurologist is doing an ovarian biopsy on *me.*  And no immunologist is doing my leg angio.

(those were different episodes)

Also they slow down the diagnostic process -- generally you'd get half those tests in emerg before the emerg doc even *called* the specialist.  Aphasia?  ECG, chest Xray, CT/MRI, LP if the CT is clear, blood/urine tox screen, bloods including micro exam.

Then the specialist team spends a lot of time reading stuff on the Internet to figure out what the emerg guys haven't gotten to.

But then it would be a *really boring* show.

And, they *do* get the whole brainstorming/differential diagnosis thing pretty close.

I also kind of like the idea you could have a team of specialists who see one patient a week, the patients noone else can figure out.  That would be fun.

So I forgive them for the sake of drama.

...

(side note)

... I had a guy in emerg, going to die likely, and the wife said, "It's not like ER on TV, is it?"  Guy and I gave her a look.  "Well, there's no music or anything, it's not nearly so exciting."  Pretty sure guy was finding it exciting enough for *his* tastes.

--ncc--

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Oh, MAN! I went out to dinner with a friend last night and missed it! I fucking love House! Hugh Laurie rocks.  Guess I'll just have to wait for the re-run.  And Topamax *swoon*...they used Topamax in the show...

...okay, yes, I Love House.  I am officially a spaz (but you all knew that anyway) who gets off on medical reality and/or drama shows.  "Untold Stories of the ER" anyone? That one just makes me laugh.

Good critiques, ncc.  You sound like me and I'm not even in the field! I'm like, "Oh, that's not how it works! That would never happen!"

Karen

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Heya Karen,

Like, how they would *never* deliver a kid in the emerg, because after 20 weeks, you don't *go* to the emerg, you go to OB triage.

Heehee.

When we were med students we used to watch ER in groups, to yell at them.

House -- and Scrubs -- and the newer emerg portrayals on ER -- ... much better, but still, nobody does CPR right.

M*A*S*H* is *still* the best medical drama out there.

House is pretty close.  I tell my family to watch it.

Have fun with the rerun.  House is one of those shows where watching reruns is *great* even if you've seen it before.  I see most of House in reruns or on tape, yes I'm lame and don't have PVR.

--ncc--

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Like, how they would *never* deliver a kid in the emerg, because after 20 weeks, you don't *go* to the emerg, you go to OB triage.

<{POST_SNAPBACK}>

Actually, it can happen in an american government indian hospital.  If they don't make it to OB triage.  It's been known to happen.  They've actually delivered them in walk-in!

That's the indian hospital for you.

Maddy -Proud Creek Indian- Mad Hatter.

    Yeah, I'm a crazy Indian!

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M*A*S*H* is *still* the best medical drama out there.

oooh.  i LOVE house b/c hugh laurie is just so awesome.  but mash is so close.  dammit.  i can't choose between the 2.  mash is sentimental for me, but house has hugh!

House is pretty close.  I tell my family to watch it.

Have fun with the rerun.  House is one of those shows where watching reruns is *great* even if you've seen it before.  I see most of House in reruns or on tape, yes I'm lame and don't have PVR.

--ncc--

i rented the first season on DVD from netflix and have it basically memorized.  house is just great.  hugh is so good at playing snarky ass. 

i only wish that all my snarky ass docs who were that rude had been as good as he is.

though have you noticed that most of his patients tend to go into seizure at some point?

on the "Extras" on the DVD (i hate dvd extras, they are useless, yet i always watch them... i was hoping for more hugh interview. but there wasn't that much) the woman who plays cameron was like "i think i could maybe intabate" and i just laughed. riiiight. cuz faking it on tv = med training.

somedays i wish i had a house to figure out what's really up with my system.  i have a really good internist, but it's just such a slow process sometimes... ah to live on TV.

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Heya,

OK, here in Canuckistan, Native or not, in the city, it matters more how fast you can get to the nearest hospital of any kind.

In rural/remote places, Native (mostly, that's where our government put most of the reserves) or not (lots of other people too, like my family) it's whoever you can see without traveling.

Experience differs.

In Northern Ontario for example, where I work sometimes, I might end up having any old procedure in the emerg, even up to and including brain surgery (a case has been reported by the SRPC).

I would *hope* that in the city I could do better.

Maybe OHIP doesn't suck as much as we all think it does.

That said, a Canadian medical show would be *much less interesting* because the whole "insurance" thing is kind of dull, like who gets a single room or not.

It's all about the *drama* after all.

--ncc--

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That said, a Canadian medical show would be *much less interesting* because the whole "insurance" thing is kind of dull, like who gets a single room or not.

<{POST_SNAPBACK}>

Heh.  Yeah, that'd be pretty much what it would come down to, alright.  Canadian show.  Hmmm...what else?

:stares vapidly into space:

I/we can only speak for Ontario, I guess and yeah, covered, covered, covered...

Although we don't have that county vs. private hospital thing? Maybe I'm not getting that right? We just have...hospitals.  Again, it's all covered so universal care.

Karen

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What about Criminal Minds with Mandy Patinkin.  There's also the pseudo-Aspie Dr. Spencer Reid on that show...or at least he was kind of suggested/portrayed that way as another "bad guy" character made references to his pseudo-autistic tendencies in one episode.

<{POST_SNAPBACK}>

Is this a current show? I love Mandy Patinkin. Anyone ever watch Chicago Hope? I loved that show.

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Heya,

Criminal Minds is a neat show where they do profiling.  The cast is a bit funny -- Greg from Dharma and Greg, Malcolm from Y&R, among others.  Led very well by Inigo from Princess Bride (*that's* a reference I'll take some heat for, I'm sure ;) ).  It's in its first season and with luck it'll have a second.

I used to like Chicago Hope (also starring Inigo -- and yes, I am familiar with Patinkin's singing and acting, I just can't help myself), too, back when it was on up against ER.  I was the only one who would admit to watching both Chicago-based doctor soaps.

Speaking of.

--SPOILERS-- (little ones)

If anyone will admit to still watching ER -- Does anyone think maybe Abby is cycling up a bit with the pregnancy?  That was how she struck me last night. 

If I was consulting on that show ... well, I would straighten out a lot of jargon.  But I would think of making her manic in the pregnancy so she would have to struggle with med issues.

And what do we think of Sally Fields' performance as bipolar mom when she's been on?  I wasn't dx'd yet, but in my memory I seem to think it was well done.

Didn't like Crumbs, though.  Within the first five minutes there was a dumb schizophrenia joke (two schizophrenics acted all the parts in some production, haha) that turned me off.  Later, it became apparent that (unfortunately, because they have an interesting cast) it's also just not funny.

Maybe it'll pick up but on the whole as a TV watcher and a crazy person I was not impressed with the pilot.

--ncc--

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