House MD is one of the most entertaining medical shows out there… but that doesn't necessarily mean it's the most accurate.

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Doctor Reacts To House MD Obesity Episode | Medical Drama Review

house i'm looking at you sir are you gonna give me a zebra or a horse i don't know let's check it out on this house md medical review what are you kidding me tub of goo there's gotta be over six bills you ain't gonna lift it with a couple of blankets no this is totally einstein yeah just just roll him off but he's already dead ain't like he's gonna feel it this is actually a situation that some of my paramedic friends discussed with me about legitimately having trouble getting humans outside of their homes into the ambulance and into the er there's even been times that i've heard them talk about injuring themselves bringing patients out of their homes because they were perhaps overweight or obese or perhaps their environment wasn't safe all right one two come on man me you're the killer boss kid wasn't me oh whoa it wasn't me either don't look at me is the patient alive did no one check for a pulse trust me skin's cold pupils are fixed and dilated he's not breathing he's got a pulse he's not dead if he has a pulse 46 year old guy in a coma doesn't appear to be anything wrong with him except for the fact that he weighs over 600 pounds who says that who who talks about a patient's weight like that and says there's probably nothing wrong do you know that do you know his history he can't even give you his full history there's no way you could have results this quickly like at least get an echocardiogram blood sugar's normal cholesterol is lower than mine toxic screen's clean no sign of trauma sure there wasn't a mix up with the lab three times i'm glad that they rechecked because if a clinical picture meaning what a patient looks like behaves like or symptoms are like don't match the labs you should be rechecking those labs too many times i've had that happen recheck the labs and find out they're completely normal or the other way completely abnormal so i always like to keep laboratory error in the back of my mind or in the front of my mind the forefront of my mind my mind there's nothing abnormal in the eeg or the neurological exam who gets an eg when a patient just rolls in it's too soon you should get a cat scan see what the lungs are like get an echo see what the anatomy of the heart is like you should see what the digestive system is like with a cat scan when a patient comes in and you don't know what's going on you have to throw all the tests at the patient in order to understand what's going on you need to check for substance abuse you need to check for toxic metabolites complete metabolic panel the complete blood count look at all these values and not just jump to conclusions i mean like doing an eeg seems like the 50th step and they've skipped over 1 through 49. improperly prepared puffer fish can have toxins that could cause a coma and might not show up on the talk screen and if it was a puffer fish he'd be dead in six to eight hours time so he's been in a coma at least 24. how do people know this fact about puffer fish come on foreman you didn't know that you googled it he googled it this is ridiculous a person shouldn't be able to eat themselves into oblivion and then just expect everyone to pull out the stops to fix everything what are we supposed to do refuse treatment to anyone who's obese come on give me a break disguise on my face he's not even morbidly obese he's suicidal people who attempt suicide get treated when you have non-compliant diabetic stone wait non-compliant diabetics do get treated i don't know why he said that and patients who are addicted to food or perhaps have an emotional issue that is causing them to overeat and become 600 pounds or perhaps have a medical condition that's causing them to gain this much weight shouldn't be judged like you can't be a doctor and be this judgy and be successful as a clinician you should do an lp with neurosyphilis it's not syphilis how do you know whatever he has is connected to his gut now what's below it mra his brain look for clots she said that the blood was drawn three times in that time they couldn't check for syphilis one two three not gonna lie this is a true challenge for hospital and hospital systems when patients can't fit in the equipment that's why we are trying to create newer equipment that is more uh capable in handling patients of all different sizes and shapes no bleeds clots influx i don't see any edema either so what do we do now an lp even if it's not an std a fever boys towards some sort of infection i'm not sure we can do an lp on a guy his size did they get a chest x-ray like if you at least had a chest x-ray you could do that portable you could do it right in the bed you could see if that there was a lung infection you could rule that out check the urine see if there's a urinary tract infection with the pylonephritis going up to the kidneys like why aren't they talking about the most common things this show is all about zebras not horses remember that saying when you hear hoof beats think horses not zebras doesn't mean you forget the zebras just means you think the horse is first calm down man calm down get him out already i'm trying we still have no idea why he was in the coma to begin with or why he woke up what if it is hormones acute adrenal insufficiency could cause a temporary coma it can and also a thyroid storm can cause a coma although a thyroid storm would probably come with a rapid heart rate also not weight gain if you have a hyperactive thyroid although if you have an underactive thyroid followed by thyroid storm which can happen because the thyroid even in like certain uh conditions like hashimoto's and graves disease sometimes it flips on and off between hyper and hypothyroid it's not always so clearly defined especially in the beginning of the onset of disease to later stages of disease we should do a full std panel and check his genitals for shankers well first of all you should have checked him for shankers beforehand and you should have done a full sed panel beforehand it's like the cheapest test you can do if you're talking about all these mris that you're breaking costing millions of dollars the 300 std panel would have been worth it don't you think are you having any problems with your vision no i have nystagmus i've had it since birth i'm fine you're not fine you're in a coma for two days there's something wrong with you was something wrong with me now i'm better now i'd like to go home the patient can always leave like if he can think about the consequences if the patient can verbalize those consequences and it's safe for them to leave in that sense they can choose to leave they will leave against medical advice which is an ama but it's within their rights it's patient autonomy wait let us take you all the way outside i'm fine uh it doesn't matter it's hospital rules oh screw the rules i've been on my back for four days i need the exercise right george come on let us just take you to the taxi don't worry i may not be able to climb everest but i can walk [Music] first of all if a patient has not gotten up since he's been admitted to the hospital would get a pt evaluation to see if he's capable of walking on his own and if he's not he cannot safely go home alone he would at least need to go to a subacute rehab stay where he could learn how to walk on his own and take care of himself cause if a patient can't get up and walk you're essentially setting them up for failure by sending them home [Music] i think we should focus on the coma and the fever we have a rather large piece of tempered glass that begs to differ i just mean it's not connected how could you possibly know because i did it i didn't think he should be discharged so i gave him three grams of benaton what hospital is this she drugged the patient so he wouldn't leave oh my god don't poison your patients even if you think it's right for them because you are not god what would happen to her medical license lost we'll do it in order they find out medical review committee medical board suspension followed by medical board revaluation followed by loss of medical license either temporarily or forever depending on how angry the patient is prior situations etc etc lawyer up it can't be chagas he's never been outside the country his stomach has the food we eat no longer comes from america's heartland it comes from south america's deforested jungle land where lettuce now grows and let his pickers now poop get a sample of his csf how are you gonna get a sample of this cerebrospinal fluid that's gonna be tough you wanna drill a hole in my head it's gotta be something other than a parasite i buy my produce it's the best market in town and i always wash it leafy vegetables can set contaminated water through the roots right into the plant i've never heard this this sounds far-fetched but i hope they research this please tell me this is a neurosurgeon doing this not like foreman it's forming oh my god these they're all neurosurgeons infectious disease specialists family medicine doctors cardiologists they run mri machines oh cramp what what'd you do nothing what's wrong i can't i can't see vision's blurry or you've lost i didn't lose it you took it from george calm down i can't speak this is actually why patients are kept awake during some neural procedures because in case you do touch something you want to know right away so that you don't continue doing damage in that area blindness plus coma says diabetes no blood sugar urine dipstick and hemoglobin a1c are normal we're normal when you test it spin it out of a coma whatever's going on is waxing and waning that's not true because the hemoglobin a1c gives you an average of the blood sugars over the last three months so it doesn't mean it was normal today it could be different tomorrow it still will give you the average of the last three months so i don't agree with house here i am not diabetic the sooner you drink this the sooner i get to go waste my time with something else get the hell off of me no dessert till you finish your dinner such a classic house situation where he's just losing his mind fighting a patient go wait his liver is failing now he's jaundiced what's happening get x-rays of his hands tell him that lung cancer is in no way connected to obesity uh you don't think he'll realize we're lying you're not lung cancer's got nothing to do with makes about him having lung cancer he didn't notice his fingers i noticed they were fat you should have pissed them off he would have grabbed you and you would have felt the bones they're not just fat they're clubbed [Music] this is the first x-ray they're getting are you joking he was in a coma in the icu and they're just getting an x-ray now oh they're getting an x-ray of his hand i thought this is the first chest x-ray they're getting your tests were positive you have a small cell lung carcinoma it caused a perineoplastic neurologic syndrome perineoplastic basically means that as a result of having this tumor it secreted hormones that have altered the way that his body behaves it's inoperable but there are radiation treatments available [Music] they might give you a few more months i never smoked not all lung cancer cases are caused by smoking some are caused by asbestos i would ask if he had any questions at that point i mean you're just delivering a life-changing diagnosis you spend 10 seconds and you leave i think that's kind of cold check out the harsh reality of being 800 plus pounds here click it check it out as always stay happy and healthy

Dr.

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