Family Practice (House)

"Family Practice" is the eleventh episode of the seventh season of the American medical drama House. It first aired on February 7, 2011.

Plot

Cuddy's mother Arlene (Candice Bergen) is brought to the ER and is placed under House's care, but he thinks she is imagining most of her symptoms. She refuses treatment from House after he demonstrates that giving her placebos, made to look like a drug which has certain side effects, makes her develop some of those side effects, thus proving that at least part of her problem is hypochondria.

The case is transferred to Dr. Kaufmann, but Cuddy has House stay on the case, unbeknownst to the mother. Meanwhile, since Masters thinks that treating a patient who expressly refused to be treated by a certain doctor is unethical, House has her run inconsequential treatment on trivial cases.

House and his team deduce that Arlene has endocarditis, while Dr. Kaufmann had her started on prednisone, which would make endocarditis worse. House tries to make his team switch Arlene's IV to give her antibiotics instead of prednisone, and after Chase, Foreman, and Taub are unable to do it because of various interferences, he has Cuddy switch the medication. This only leads to Arlene developing an allergy, so she is taken off the antibiotics.

Masters wants to disclose the situation to Arlene, but House tells her he will have her thrown out of medical school—and he has the means to do it, because he has set her up with the trivial cases he had been busying her with. One of those patients had prohibited treatment without express consent of relatives, House hid this from Masters, and she drew blood from him, which, according to House, would constitute a criminal assault.

House, his team, and Cuddy talk about the dangers of slipping the patient drugs without the knowledge of the attending physician, now that they have moved on to a diagnosis of fungal endocarditis which requires giving her a dangerous antibiotic. Before the situation is resolved, Masters tells Kaufmann and Arlene what House has been doing.

Arlene asks to be transferred to Princeton General. Cuddy caves in and orders an ambulance to get her to the other hospital. Before Arlene can leave, however, House makes Cuddy realize she's been unable to confront her mother, which can now cost her the life of her mother, but sooner or later she would blame this death on House. Cuddy gathers her courage and talks to Arlene, making her stay in Princeton Plainsboro.

While House and Cuddy prep her mother for treatment from fungal endocarditis, their small talk reveals that as far as two days ago, Arlene was unable to detect House's sarcasm in a conversation with him. House determines this to be caused by a deficit in the right parahippocampal gyrus.

Immediately after that, Arlene faints, with her heart rate skyrocketing. House diagnoses heavy metal poisoning. Arlene had already been treated briefly for possible lead poisoning, got better, but then got worse again, so House concludes she continues to be poisoned—by her artificial hip. After an operation and chelation for cobalt poisoning, Arlene recovers.

House once again "unfires" Masters, because he feels that, now that Cuddy is his girlfriend, she's becoming too soft on him, and he needs someone to stand up to him to keep him from doing something unethical in extreme cases. Earlier, this had always been Cuddy's role as his boss; now that she's his girlfriend, he thinks Masters could fulfill this role.

The only other storyline in the episode deals with Taub, who's pressed for money now that he had to move out and live in a hotel. He gets a referral by his ex-wife to her brother, a torts lawyer who needs a medical expert. A side glance at a brain image he finds in the brother's office makes Taub think a boy who was run over by a pizza delivery truck and is getting a settlement for legs trauma, also has a minor bleed in his brain.

Taub informs the boy's mother, she calls off her assent to a settlement and reports the lawyer to the bar for trying to hide additional damage. An angiogram shows it was nothing, and the lawyer arrives at the hospital to beat Taub up—as he did five years ago when it was revealed that Taub was cheating on his wife, the lawyer's sister. Thus the lawyer's five years of therapy—presumably for rage fits—turn out to be for nothing. Taub's wife comes to him to say he's a good person and console him for his broken nose and the blown chance of finding additional income.

Reception

Critical Response

The AV Club gave this episode a D+ rating.^[1]

Lancet Case Report

This episode was cited in the well known medical journal the Lancet as helping Doctors in Germany to diagnose a case of cobalt poisoning from a hip prosthesis because they use House for teaching medical students.^[2]

References

External links

• "Family Practice" at Fox.com
• "Family Practice" at the Internet Movie Database
• "Family Practice" at TV.com
• "Article in Lancet"