True confession: I try to watch the medical drama House when I can. It’s lead character is an acerbic and brilliant atheist M.D. (played by Hugh Laurie, a comedic actor—which was a smart casting decision), and the humor is snarky and dark. That’s just the kind of thing I enjoy. It’s been going downhill, I think, because the episodes have gotten far too predictable—there’s always a weird illness which is handled via increasingly wild semi-random diagnoses that always, and I definitely mean always, ends with the complete cure of the patient. The infallibility is wearing a little thin.
Last season’s finale almost made me give up. They turned the gross-out factor up to 11 (exploding testicles and eyeballs popping out), and resolved everything with the lamest, laziest television cliche: it was just a dream. I hoped it was just an aberration.
Last night’s episode, though, blew it. I have lost faith in House. <spoilers below>
The premise was a sick kid with rectal bleeding and hallucinations of being probed by aliens. To jump way ahead to the resolution, the kid was chimeric, the product of a fusion of two zygotes in utero, and so he had cells of two genotypes in his body. That isn’t too unlikely a possibility, but everything else was. How they figured it out peeved me no end.
First, there was a problem with blood pressure, so after the usual series of confusing red herrings, they do an echocardiogram of his heart. It’s an amazingly pretty pseudo-colored rendering of a valve opening and closing which had me a bit dismayed, but OK—the CSI-ification of science continues apace on TV, with the most wonderful technology always doing the job with the most glitzy interfaces. I’ll let it slide. It’s stupid, but I’m trying to watch it for the characters, OK?
They notice that a part of the heart wall isn’t contracting properly, so they go in and snip out a piece of tissue from the heart of this 7 year old. That was cold. You’d think they’d then try to figure out why it wasn’t contracting, and they’d send it off to a histologist, but no…continuing the show’s history of randomly picking some inappropriate diagnostic tool, they send it off to have a DNA comparison done. Why? I don’t know. It comes back as a different genotype than the kid’s other tissues.
I figured that one out immediately: it’s tetragametic chimerism. And this is the instant where the show completely lost me: these brilliant, insightful doctors sit around wondering instead whether the kid might have consumed a mutagen, a possibility that made no sense at all and wouldn’t produce the kind of variation they were seeing. Dr House sees it later in a flash of insight.
Their treatment is then baffling. They want to find all the cells of the foreign genotype, so they whip up a tagged monoclonal antibody (in the space of hours; curse you, CSI), inject it into the kid (What? Provoke massive antibody binding to the tissues of your patient?), and trundle him into an MRI to visualize the binding (MRIs are magic imaging devices, you know.) Poof, all these trouble spots light up: there’s a patch in the bone marrow of his leg, which is why his blood sometimes fails to clot, there’s a patch in his heart causing hypertension, there are some in his eyes, which is why he wears glasses. Later they find more in his brain, which is why he has hallucinations.
Why chimeric tissue would cause all these problems is not explained.
The cure, though, is very easy. They go in and surgically cut out all of the tissue: cut out part of his heart, remove the bone marrow from that leg, scrape his brain. The funniest (unintentionally, I think) bit was where they stick a needle in the kid’s eye and somehow selectively suck up retinal cells…and his vision is immediately perfect! Throw away those glasses, all you need is to get your alien photoreceptors to spontaneously emigrate! Chimeric tissues are fully integrated with each other and their functions are indistinguishable from one another, barring some specific genetic difference, so this whole sequence was impossible and nonsensical.
I know these medical dramas are long on false tension and will try to slide past difficult problems with random Star Trek style jargon—I’m hoping one of them will propose examining a patient’s Jefferies Tubes someday—but the writers should attempt to at least put up an illusion of competence. You know, run it past a science/medical advisor, and after she’s done laughing, ask her to help tune up the plausibility a notch. It doesn’t have to be accurate, but there at least has to be an effort at verisimilitude, the tiniest nod in the direction of your viewer’s intelligence. All I can see in the show now is that it’s about a sarcastic atheist who is also an idiot, and the writers also think I am an idiot.