House: Under My Skin
by Hemal Jhaveri, posted May 5th 2009 12:45PM
(S05E23): Aside from whatever people think about the House/Cuddy relationship, and no, I'm not going to give it a cute nickname like Chuddy, or Huddy or whatever people on the Internet forums are going by, can we agree that Hugh Laurie is indeed awesome? While this wasn't the most brilliant episode of House, Hugh Laurie really shines when it comes to depicting House's inner turmoil, and he had plenty of material to work with last night.
The cold open of the show focused on a dying ballerina, but the real patient of the week is House himself. While the team tries to find out why Penelope the ballerina's skin is falling off in gross, bloody chunks, House tries to diagnose himself, and figure out what's causing his Amber-vision.
So, Amber is still around and making a pest of herself, causing House to lose the one thing he values most, his ability to think rationally. And we all know how much House values rational thinking. For him to lose that part of his mind, and not practice medicine, which is his entire life, would be devastating. Like the pretty ballerina who doesn't want to live if she's not able to dance, House doesn't want to live without his ability to practice medicine. His worst fear isn't death or loneliness, it's not being able to practice medicine.
Finally enlisting the help of Wilson, House runs through every diagnoses from MS to Schizophrenia, trying to find the least scary option. It's Wilson who comes up with the most reasonable and rational, but equally devastating conclusion: House's hallucination isn't caused by some underlying neurological disorder, but rather, is a result of the outrageous amounts of Vicodin in his system. His only choice to rid himself of Amber is a painful detox.
The scene where House realizes he needs more help than he initially thought, the one where he's 'celebrating' at the bar after going into insulin shock, with Amber's creepy voice drifting over him, is tremendous. You can see the sheer terror in his face as calls Wilson and asks for a ride home. In a flash he goes from smug bastard to utterly pathetic drunk. It's brilliant.
And Wilson again plays the long-suffering but dutiful friend. He knows House is in pain and tries his best to help. I really liked the scene between House and Wilson early in the episode, with House and Wilson arguing, and Amber being is annoying subconscious. It showed just how hard House has to fight himself sometimes, despite having good intentions.
Regardless of how good a friend Wilson is, House knows he'll be able to easily manipulate him and the rehab center into scoring Vicodin. Knowing this about himself, House turns to Cuddy. Now, I'm not really sure I buy the premise that Cuddy is really the only one who can stand up to House and therefore get him through this. They've down a pretty good job of showing that Cuddy generally backs down from House when push comes to shove, so I just don't get why it would be different this time around. But, I guess it is. If anything, it should have been her and Wilson together that get House to detox, but whatever.
To get rid of Amber, House goes through a pretty painful detox where we see just how desperate he's become. It's gut wrenching to watch him crawl across the bathroom floor for that one pill. Now, the detox scene only lasts one harrowing night. I find that hard to believe. Do people really come down off a serious drug addiction after only one night? Wilson's rehab idea sounded like it would be a few weeks at least. I'm all for the idea of House detoxing off of Vicodin and us being able to see what he's like without the drug, but that happened way to fast.
At the end of their long dark night, Cuddy and House kiss. Now, I'm all for this relationship, but it feels like the entire Amber plot line, and House's detox, was just leading up to this. It's good to see House finally acknowledge that he has feelings for Cuddy, and we see him in a rare, vulnerable state, even if it's only temporary.
Honestly, I'm a little glad my DVR (once again) cut off slightly early. House and Cuddy going at it like a couple of teenagers made me want to cover my eyes. It's like catching your parents making out. No one wants to see that. I am fan of the House/Cuddy relationship, as long as all parties remain fully clothed.
Also, please just end the Cameron & Chase story line. It annoys me that Cameron said, in response to saving her husband's sperm, "I didn't plan on him dying..", Um, yes you did. Didn't Cameron marry the guy knowing full well he had terminal cancer? That's either Cameron being emotionally manipulative, or bad writing. Either way, it doesn't look good. Poor Chase. As vapid as he can be sometime, I admire his resolve in finally walking away from Cameron.
So, has House made any real changes? Do you think that they will be lasting and significant? And where is the House/Cuddy relationship going?
Comments
by Lucie, posted May 5th 2009
Would'nt you know it...the one time I skip watching House..and he gets some!!!
Reply
by Martin, posted May 5th 2009
Great that House goes through diagnosing himself the same way he does other patients, a lot of trial and error... Funny how like usual it took about 4 attempts to get the right one, though sad that he never thought it might have been Lupus causing Amber to appear! :(
Reply
by Midnight13, posted May 5th 2009
Hm, "House" detoxed and in pain that won't be numbed by his precious Vicoden? House is usually an SOB to people as means of his own amusment, now he's just going to be annoyed by EVERYTHING. Sure Cuddy will probobly give into him, as she always does. She'll show her own vulnerablity, like she did last night, pretty much saying she always held a flame for him. House being House will use that for his own benifit until the two can't bear to be in the same room with each other again. I think he'll be so distracted by his own pain everyone around him will beg him to go back to his meds.
Reply
by David, posted May 5th 2009
Notice what's missing from your post? Any significant mention of the 'case of the week'. Indeed, they even edited out the part between "House's staff is stuck" and "Taub's solution works". It leads me to really want to ask the writers, "why do you insist on sticking to this formula week in and week out? The real story was House and Cuddy, and you had a sidelight about Cameron and Chase. Why is it necessary to insist on giving us a patient every week, especially when you're going to shortchange the patient story via really poor editing?"
Great episode, otherwise. House has really elevated its scripts in the past few weeks.
Reply
by bruce, posted May 5th 2009
House is usually a show based in reality. But last night's episode was not.
1. Vicodin does not cause hallucinations. Insofar as it does in this world of "House", there are a plethora of other opioid painkillers he could take in place of it. Moreover, insofar as anyone can google a negative sympton like "hallucinations" and find someplace on the internet that lists it as a symptom of any controlled substance you look for (like Vicodin), House has been on vicodin for years and wouldn't just suddenly get hallucinations.
2. Hydrocodone has a linear dose to response curve. That means there are no "toxic levels" of it. There are toxic levels of acetaminophen, however, which is an ingredient in Vicodin-brand hydrocodone. And while there are "toxic" levels of acetaminophen, that just causes liver damage, not hallucinations.
3. Moreover, nobody with Dr. House's level of legitimate, long-term chronic pain would be taking Vicodin at this point. He'd be on a much stronger, longer-acting medication like Oxycontin or Duragesic. Neither of which, by the way, causes you to see dead people. Once Vicodin became problematic (a more legitimate reason would be due to the acetaminophen content, i.e. liver damage) the solution would be to switch to another painkiller that doesn't contain acetaminophen. Plus there is an easy way to remove acetaminophen from vicodin pills, and I'm sure someone as knowledgable and clever as Dr. House would know that or easily figure it out or easily look it up on the internet.
4. You can't detox Vicodin (or any other opioids) in one freakin' night. Jeez. One night of throwing up and the next morning he wakes up feeling fine - not only fine but frisky enough to be making out with Cuddy? Come on. He'd be sick for weeks, as he's been taking that medication for many years (at least 10 or 15 if I recall my House history correctly). One night?
5. Electroshock (nowadays called ECT - electroconvulsive thereapy) is perfectly safe, though still stigmatized. While it may be a last resort, that's only because there are so many easier ways of treating those things that it's used for - lots of medications to try, etc. There may be some short-term memory loss, but that's it, and that's worst-case scenario. Plus it's done under anesthetic, so it's not like One Flew over the Cuckoo's Nest. But even so, there's no legitimate reason to think ECT would fix "Vicodin hallucinations" because there are no such thing.
6. What about House's chronic pain? Why is this show demonizing his medication to such an extent? These are doctors, they should freakin' know better. Is the DEA the new showrunner for House? Made-up drug war propaganda (Vicodin hallucinations!) is where they're getting the show's plots now? Did they credit the "Drug Czar" as a writer? Unbelievable.
Reply
by jffm, posted May 5th 2009
bruce said...
1. Vicodin does not cause hallucinations.
recoveryconnection.org: "As the Vicodin addiction progresses and tolerance increases, more significant symptoms tend to occur... in the late stages of a Vicodin addiction, (symptoms may include) hallucinations."
rehabinternational.org: "As a person gets addicted to Vicodin the side effects can get worse and result in blurry vision, severe confusion and hallucinations."
Women's Center for Healthy Living: "The physical effects of Vicodin addiction include, but are not limited to: Confusion, Constipation, Dizziness, Hallucinations..."
by Paul, posted May 5th 2009
I'm glad I don't watch TV with your sense of true realism. BESIDES the fact that we have no way of knowing if the hallucinations are ACTUALLY gone for good, who really cares if the vicodin can cause hallucinations or not?
Well, obviously you do, but I'm glad that I don't. I don't look to "House" for medical knowledge. I look to it for drama and humour. And this season has been top-notch with both.
by bruce, posted May 6th 2009
It depends on the show. I love Fringe, despite its blatant lack of realism. But House holds itself out to be a medical show based on real science, with real medical mysteries. To just make something up is quite horrible. Moreover, the way the show continue to demonize House's pills (which he clearly and legitimately needs, as the show has unquestionably established) is even worse. The issues of opiophobia and untreated chronic pain are serious ones that should not be belittled or misstated. If "House" wants to go the way of pyrokinesis, mind reading, psychic phenomena, and spontaneous human combustion then I'll hold the show to a different standard with respect to believability.
Also, just because I see flaws with a show doesn't mean I don't enjoy it, or don't enjoy the experience of watching it. I was entertained for the hour I spent watching this episode of House, yet I feel compelled to point out the horrible flaws with the episode. It was not a good episode. It was a really crappy one, in fact, and that should be pointed out.
by Wii60, posted May 5th 2009
Setting aside the ridiculous notion that you can detox in one night, these last two episodes were so awesome.
Seriously, this is the best written show on TV.
Reply
by xnifex, posted May 5th 2009
please don't let amber be gone. i really like anne dudek!
Reply
by Fullman, posted May 5th 2009
Seriously, the scene in the bar with the ominous music and Amber singing in a really, creepy voice and seeing the terror on House's face really made me ridiculously uncomfortable. That's what made it a great scene!
Reply
by Willmore2000, posted May 5th 2009
House and Cuddy sitting in a tree
K-I-S-S-I-N-G
Reply
by bruce, posted May 5th 2009
One other thing that really bugged me about this episode.
7. Why not a single mention of rapid, naltrexone-induced detox? House did that to a patient a long time ago (young model addicted to heroin). You're put in a medically-induced coma with barbiturates, and then your body is pumped full of naltrexone (opioid antagonist) which makes you go through extreme withdrawal in a short period. Kinda flushes it out of you. When you're woken up in a day or two, the worst of the detox is over. But even then, you still feel pretty crappy - too crappy to make out with your boss, for sure. Why was this not even mentioned as an option? I guess because in the world of House, one can simply do an "overnight detox" on your own, which invovles feeling bad for about 12 hours and then it's all over - back to normal. Why wasn't this an option for the young model back in season 1 or 2 (whenever it was)?
jffm: Like I said, name any controlled substance and name any negative side effect, and you can google a page that lists the side effect as a consequence of taking the controlled substance. AIDS and marijuana, cancer and cocaine, brain tumors and valium, scizophrenia and oxycontin, melanoma and crystal meth. There are anti-drug pages out there which are more than happy to publish false symptoms/side effects of drugs they don't want you to take. I've known plenty of long-term chronic pain patients, as well as many pain management doctors and I stand by my statement that no person has ever hallucinated from Vicodin alone. Maybe vicodin plus LSD. But that's because of the LSD.
Now, there is some evidence that people going through opiate WITHDRAWAL have had hallucinations. There's a famous scene in the movie "Trainspotting" about that (baby on ceiling). But House was not going through Vicodin withdrawal when he was seeing Amber - he was on Vicodin at the time. They are saying withdrawal was the CURE for the hallucinations. That's absolutely bullshit. The only time House would have plausibly seen hallucinations was during his one night of "extremely rapid detox." Even then, that's an extremely uncommon side effect of opiate withdrawal. But it's absolutely not a side effect of opiate use.
Reply
by jffm, posted May 5th 2009
"jffm: Like I said, name any controlled substance and name any negative side effect, and you can google a page that lists the side effect as a consequence of taking the controlled substance. AIDS and marijuana, cancer and cocaine, brain tumors and valium, scizophrenia and oxycontin, melanoma and crystal meth. There are anti-drug pages out there which are more than happy to publish false symptoms/side effects of drugs they don't want you to take."
Just trying to figure what's what. You've stated that Vicodin doesn't cause hallucinations. A quick google turns up more than a few sources saying otherwise.
A doctor out of Indianapolis writes a blog called Polite Dissent that reviews the medicine on each episode of House and while he was pretty scathing of the medicine in the patient of the week portion of the show, the only quibble he mentions concerning the Vicodin is regarding the use of the terminology "Vicodin level". No mention of Vicodin causing hallucinations as being problematic.
by ciel, posted May 5th 2009
I havenīt seen him already!!! so I skipped your comments so you wouldnīt spoil it. I am getting ready to watch it now!
I love DR House. For those who missed it!
Hilarious Bloopers and an alternate take between Cuddy and Cameron!
http://hahaha-havealaugh.blogspot.com/search/label/Bloopers%20Dr%20House
Reply
by bruce, posted May 5th 2009
jffm: If you can find one actual, reported case of someone who had been taking vicodin for an extended period and then suddenly began having hallucinations as a result of the vicodin, I will concede my error. But I stand by my statement.
Maybe someone could have some extremely odd allergic reaction to the drug, get a high fever, and as a result of the fever have hallucinations. But there was no indication that House was allergic to vicodin. And what they're really implying is that all opioids cause hallucinations. That's because nobody suggested switching to another painkiller. It was either detox and suffer pain, or have hallucinations from the medicine.
Reply
by jffm, posted May 5th 2009
bruce said...
jffm: If you can find one actual, reported case of someone who had been taking vicodin for an extended period and then suddenly began having hallucinations as a result of the vicodin, I will concede my error. But I stand by my statement.
Like I said, just looking at what's out there one way or the other. No interest in concessions. Right now, there happens to be a lot more showing up on the "yea" side than the "nay" side.
by chaosorder, posted May 12th 2009
http://www.druglib.com/adverse-reactions_side-effects/vicodin/seriousness_hospitalization/reaction_hallucination/
I believe that has documented cases of Vicodin causing hallucinations in more then one instance?
Reply
by Michelle, posted May 15th 2009
Seriously guys, it's a TV show. It's NEVER going to be realistic. Even CSI admits that tests that take days or even weeks in real life are done in hours or minutes in the show. And many of the diseases on the show are misconstrued and the symptoms put in the wrong order or even just added in in order to make it more interesting. Besides, the detox will probably take course over the whole next season (if it lasts that long). I realize it's fun to talk about how unrealistic a TV show is in certain points you're interested in. Even I do it, but you don't have to be so serious about it.
Reply
by rachael, posted May 27th 2009
bruce,
Thanks! It's nice to know that there are other people out there who who also think the concept of hallucinations caused by "Vicodin overdose" and the fact that House is still even taking Vicodin anyway is ridiculous.
I love House and it's one of my all-time favorite shows. I suspect that the reason House takes Vicodin is because Vicodin is something that people know about, but talking about "Vicodin levels" and hallucinations and so on really stretches it for me. I agree with you, at the very least he'd be popping OC 5's or something else without acetaminophen.
I also think it's amusing that when House takes a pill, he seems to feel its effects immediately. In reality it would take at least 20 minutes or so.
OF COURSE it's a TV show and thus somewhat unrealistic, but people still learn from TV shows.
Reply