Role Model (House)

"Role Model" is the seventeenth episode of the first season of House, which premiered on the Fox network on April 12, 2005. The episode follows a presidential candidate, Senator Gary H. Wright (D-NJ) (played by Joe Morton), following a stroke, while continuing the feud that has developed between Vogler (Chi McBride) and House (Hugh Laurie). The ICU nurse who attends to the senator is the on-set medical adviser on the show, Bobbin Bergstrom.

Plot

African American Presidential candidate Senator Gary H. Wright vomits and passes out at a fund raiser. Vogler offers not to force House to fire either Cameron or Foreman (Chase is safe as he is feeding Vogler information) if House treats Sen. Wright and gives a speech supporting Vogler's new drug at a conference.

Foreman finds a scar on Sen. Wright's tongue from a childhood accident and a lack of reflexes (e.g., patellar reflex), which indicates a neurological disorder. Tests show that Sen. Wright has Toxoplasmosis strongly indicating an immunodefence weakened by AIDS. The first HIV test is positive, but a second one is negative. As the senator's condition worsens, it becomes impossible for House to run further tests for the Hairy cell leukemia he believes the senator has. However, viral tests clue House to the fact that Sen. Wright's problem stems from a childhood epilepsy treatment (phenytoin). As Sen. Wright's condition improves he tells House he is still running for President even though he knows he will not win, because he believes it will make the path easier for those who follow him. Meanwhile, in the clinic, House diagnoses a woman complaining of bruises and rashes with sexsomnia.

At the conference, House gives an extremely brief (two-sentence), monotonous and lackluster speech in a weak attempt to pacify Vogler. However Vogler is not satisfied and orders House to step it up or he will force him to fire either Foreman or Cameron again. House then returns to the podium and tells the ugly truth about Vogler's drug: it's not a new drug at all, but rather an old drug whose patent is about to expire, forcing Vogler's company to reformulate it with an additional medication to create a "new" drug, which they will encourage doctors to prescribe rather than the soon-to-be less expensive old drug that's about to go into generic status. House's staff, all present for the speech, react in ways showing their disbelief (Foreman shakes his head, Chase downs the rest of his glass of wine, Cameron looks torn between admiration and sorrow). House sarcastically mentions to Vogler, "I threw in a joke" (after Vogler had earlier asked him to), leaving Vogler to speak to the audience. That night, Cameron makes the decision for him, going to House's apartment to quit her job. She tries to shake his hand, but he refuses. She says "goodbye, House" and walks out the door.^[1]

Medical errors

• Even though intravenous immunoglobulin (IVIG) is an option for treating CVID, it is typically contraindicated in the presence of an infection due to the increased risk of an anaphylactic shock.
• The time required for a CVID patient to recover a near-normal immune system would require several months following treatment, so this was shortened in the episode for the sake of dramatic effect.
• Toxoplasma (presumably Toxoplasma gondii) is not a fungus, it is a protozoon. Ironically, in an earlier episode ("Maternity") it is implied to be a virus.
• Upper motor neuron lesion presents with brisk reflexes [hyper reflexive] not absent reflex. And to be more precise upper motor neuron lesion has increased deep tendon reflex (DTR) and here they have shown absent Patellar reflex or knee-jerk reflex i.e. one of major DTR.

External links

• "Role Model" at Fox.com
• "Role Model" at the Internet Movie Database
• "Role Model" at TV.com

References