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Is Dr. House a realistic doctor?

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It's almost the weekend, so let's talk about TV.

I watch FOX's House regularly. I am losing interest in the program because (besides becoming clich├ęd and boring) it is not realistic.

The medical cases themselves are full of inaccuracies; one is tempted to uncharitably call them lies. One character is "dying" of Huntington's chorea, which in reality is not a fatal disease at all. A patient died of acute eclampsia a month after giving birth — never mind that eclampsia is cured by delivery of the baby. In one especially infamous episode, a psychiatric condition called "mirror syndrome" was completely invented out of thin air by the writers. (There is a real condition called mirror syndrome which affects pregnant women; this illness was also featured in an episode. Oops.)

Each episode begins with an apparently healthy patient dramatically (and often graphically) collapsing. They are then whisked to Dr. House's hospital, where his team of crack doctors (a bunch who apparently failed medical ethics in school) personally conduct the procedures and tests that are normally done by nurses, radiologists, and other specialists. Dr. House invariably treats the patient more callously than can be imagined, often being deliberately cruel — and clearly delighting in it. At the end, Dr. House (or, less freqeuntly, another doctor, such as the skankily-dressed hospital administrator Dr. Cuddy) has a brilliant flash of insight that tells him the patient's true diagnosis, and treatment after that is quick and easy (unless it is incurable and the patient dies, which happens fairly often).

Scientific American blogger Jordan Lite notes that the cases are often taken from the New England Journal of Medicine's clinical problem-solving column, and that one writer-producer, David Foster, is an M.D. A book has even been written about the show, The Medical Science of House, M.D. But I find the science unrealistic. This is not how medicine is works.

A real mystery disease is usually chronic. A patient with a real "zebra" condition has usually seen many doctors. Once a diagnosis is made, if it is made, treatment is not necessarily quick and easy.

Also, a good doctor is not cruel.

CNN recently featured a story on Dr. William Gahl, who is a real-life diagnostician of rare diseases. Read this story for a realistic picture of how doctors approach medical mysteries. And keep watching House, if you enjoy it. But remember that it's just as fictional with its science as Star Trek and Battlestar Galactica.

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