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House MD – Page 2 – Life as an Extreme Sport
Life as an Extreme Sport

insert bad Troi impression here

A friend and I were chatting earlier this week during the TV show House, and I did a quick math count of the amount of pain medication I have floating around my own house, at the maximum (right after I’ve filled my prescriptions) and what I have on hand currently. I mostly did this to show that the numbers they were discussing on the show weren’t as high as they were implying.

Anyhow, it came up that I really have stopped talking about having and living with a chronic pain problem. I didn’t think this was true until I took the time to look through both journals, and yeah, I guess I have stopped talking about it. I suppose part of it is, really, what do I say? “Woke up this morning. Arm hurts. Got coffee. Dropped yet another mug, because at early’o’clock I can’t seem to remember to use my left arm…” I don’t want to turn myself into a victim, or a pitypoint. Yep, got a chronic pain problem, it’s irritating, it slows me down, next?

It has been implied, however, that this is just a way of holding it in and not dealing with it, or sharing and allowing those friendly towards me to be supportive. I’d argue, but I’ve been told that there are more of them than me, and I’ll lose.

I guess talking about it makes it real, and I don’t really want to make real the fact that things have been rough lately. I had a lot of writing and typing to do in the last week, which has made the general pain worse, and I seem to be having some new symptoms. I’m not certain if it’s related or not, but I’m having dissociation issues, where I can get comfortable, cross my arms or whatever, and a bit later I realize that I have no real sensation of my arms, especially my right one, existing. I can’t feel it under my left fingers, or feel my left arm under my right fingers. On top of that, which always causes a bit of a freak-out when I realize it’s happening, is the pin-pricks of upset nerves. It’s the whole tingling-when-waking-up feeling, racing up and down both arms.

Unfortunately, I suspect this might mean the problem is spreading. However, I am hoping that maybe there’s just some circulation issue going on, separate from the CRPS. I’m going to have my blood glucose checked again, too…

So that’s the health update in a vague nutshell. I’ll try to be a bit better about talking about it, but truth be told, I’m still feeling very self-conscious, knowing people actually read this. There’s the balance of information and privacy that I’m still wrestling with, and so far as the CRPS goes, I’m simply not certain how comfortable I am discussing it on any broad scale. I don’t want people seeing me as anything other than how I portray myself, and it’s hard to not feel like talking about the pain will undermine the portrayal that is out there.

The Return of House

House returns tonight, and I’m politely delaying this post for my West Coast friends. However, y’all are SOL after 12am EST. If you haven’t watched the show yet, don’t read the rest of this entry.

Anyhow, the much anticipated return of House, and perhaps this year I’ll actually start making more thoughtful posts about it. I do seem to start the beginning of school optimistic that I’ll be intelligent and thoughtful about what I’m watching; always seems to devolve quickly. Of course, the difference is that I’m going to be taking a lot fewer credit hours now, not to mention not teaching or doing anything else – this should lend itself more to thougthful analysis. Tonight’s episode, for example, is an excellent illustration of cost benefit analysis and hospital administraion (Cuddy) versus doctor desire for treatment. Of course, since this is a television drama, at the end Cuddy bends and does what’s right – which is not always what is just, ethical, or beneficial – and heals the patient with House’s cure. It was a beautiful, touching scene, and I’m a big softie so of course I cried.

And then Cuddy didn’t tell House, per Wilson. Because Wilson feels House needs to learn “no”, and this is the way he will – by not having an evidence-based reason for treatment, being told no, and learning that he must always have a scientific reason, nevermind that his entire job is predicated upon seeing clues no one else does, and he not even always understands. Ahem.

I’m not certain I’ve ever been clear just how conflicted the character of Wilson leaves me. He’s an oncologist, he should understand chronic pain. And yet he has, for the past three years, scorned House his pain, refused to help, challenged him to go without medication, and generally been a complete ass. Yet at the same time he’s endearing – a funny sense of humour, wry, sarcatic, and the perfect foil to House. But over the last year, they’ve started making Wilson into something I don’t quite like, and this episode seals it. Thankfully, it looks like the following episode will blow it right open.

There is a scene about 50 minutes in to the episode that I ache in resonance to. House is running, trying to enjoy the feeling, the floating, the freedom that comes when you’re not in pain. He overheats, and stands in a fountain to cool down. But he’s finding that high, the bliss, the feeling of adrenaline and endorphins that, if you have nastyass chronic pain, you get when you’ve pain relief and no other way.

I can’t remember the last time I felt that way without the assistance of chemical aid. The last time I’ve been able to push my body to extremes and feel joy, instead of fire.

[The Daily] – Medicine or Miracle?

Medicine or Miracle?
2006-05-30

A recent episode of the television show House titled “House vs. God” dealt with the idea of faith healing, something that comes up a lot these days in medical journals.

What is the power of prayer? Does faith healing work? Can miracles happen?

As many are aware, there have been multiple studies that attempt to look at these subjects, the strongest being that of the effect prayer has on people.

Unfortunately, even the people running these studies will tell you they are not well designed, and potentially flawed.

This came to light recently when one of the most comprehensive studies on the power of prayer showed that prayer for post-operative cardiac patients actually appeared to have a slightly detrimental effect on the patient.

Perhaps this is a reflection of my interdisciplinary training, but I think the much more interesting questions to ask are why miracles can’t happen and prayer can’t heal.

Some would say that it’s because there is no higher power, deity or God, but do we need such a being to exist for prayers and miracles to work?

After all, couldn’t you argue that a miracle is just that which we don’t understand?

You could quite often say the same thing about our medicine. The typical example is a cell phone in the rain forest, although I’d argue there’s an awful lot of technology and medicine that might as well be (and probably is) “magic” based on how well we understand it.

There is simply the belief, the faith that it will work, because someone is being told it will work.

How is that so different than hearing a faith healer tell you the same?

Of course, we of the rational, medical type say we have medicine. We can take the time to understand how technology works. We can figure it out and we can do the math.

But we cannot and do not fully understand how the body works; we keep finding new things.Miracles keep being rationalized and understood, filed away into things to learn and knowledge to distill.

If we have learned one thing, it’s that the body is an amazing thing.

In the episode of House I refer to, the patient — a young teenage boy — hears the voice of God, and believes God wants him to be a faith healer. Dr. House takes the case on after the boy collapses in the middle of a church meeting, and eventually discovers the boy has a tumor in a certain part of his brain, the result being that he experiences hallucinations — hallucinations he believes to be the voice of God.

Who is to say that the power of the placebo effect isn’t enough to help some people?

After all, we know scientifically and medically that positive thinking does positively affect our health, including helping us recover from illness.

Does it even have to be a placebo? We understand so little of how the brain works, is it so genuinely inconceivable that there are still processes left we don’t understand?

We don’t want to entertain the notion that something can be both real and invisible, quantifiable yet mystical, so it gets filed away as faith-healing fakery and fraud.

But in 10 years, perhaps it will have a Latin name and a textbook, diagnosis and belief, some way to reconcile disbelief and faith (or evidence).

That’s the way knowledge goes: a part of life for both miracle and medicine.

Why should we limit our view of the world to that science we already understand, instead of enjoying the magic and mystery behind those things we don’t?

The Daily [05-08-06] – Dependency vs. Addiction

If this looks familiar to some of the longer-time readers, well… it was a busy week. And besides, the original was pretty good in and of itself.

Dependency vs. Addiction
Publish Date: 2006-05-08

I meant this column to be about the idea of informed consent. It’s a subject both House and Grey’s Anatomy have covered in their last couple episodes; something I would call a coincidence if they hadn’t been doing this back and forth of show themes for two seasons now.

But one evening I managed to find myself on the Television Without Pity Web site, in theory rereading the details of those pertinent episodes of Grey’s and House, when I decided I wanted to read recaps from earlier episodes.

That decision led me back to a first-season episode of House titled “Detox.” The theoretical point of this episode was a teenager with bleeding of unknown origin, but the actual point was to examine the vicodin use of the main character, Greg House.

For the few of you who’ve managed to miss this show, the character likes to discover novel ways to take vicodin.

In his defense, he’s missing a good part of one of his thigh muscles and has severe nerve damage from various complications of a blood clot and surgery years before.

House is accused of being a vicodin addict, and is challenged to go a week without taking any. He accepts the challenge, and during the course of the show appears to go through withdrawal, going so far as to break his hand to force his body to pay attention to different pain.

The result? Everyone crows that House is a drug addict.

I don’t agree.

Addiction is a biological and psychological condition that compels a person to satisfy their need for a particular stimulus and keep satisfying it, no matter what the cost.

Dependence is a physical state that occurs when the lack of a drug causes the body to react.

Physical dependence indicates that the body has grown so adapted to having the drug present that sudden removal of it will lead to withdrawal reactions. This can happen with almost any drug.

House is in constant, chronic pain. The physical dependency on vicodin is one that allows the character to maintain a normal lifestyle.

To use analogy to illustrate the point, imagine that a normal, healthy person is akin to a full glass of water. Someone who is in chronic pain is only half a glass of water without pain medications.

Add in a bunch of ice cubes, and the person in chronic pain is brought back up to the normal and functional level of everyone else.

In the case of the addict, toss a few ice cubes in a full glass of water, and watch everything spill everywhere in a mess. That’s addiction.

The chronic pain person needs those ice cubes of vicodin on a daily basis to provide what the body needs to function, but it’s not a situation where they would actively seek out, need, or desire any more than necessary to achieve that state of near-normalcy.

Regular use of some medications is necessary for some people to live a normal life. A diabetic is not addicted to insulin, nor is someone taking medication to control high blood pressure addicted to it.

They are, however, dependent upon it, as a person in chronic pain is dependent upon their drugs to function normally.

Perhaps that’s the thing one needs to consider when weighing notions of addiction or dependency — the person who is addicted does not have improved functionality with their addiction, while the dependent person does.

The writers of House have been irresponsible in how they’ve portrayed the character of House’s dependency, and this causes a lot of grief for actual living and breathing people with chronic pain.

There is a stigma associated with needing pain medicine every few hours. This stigma, shame and fear prevents many doctors from properly treating pain, and prevents many people from seeking out the relief they need.

Faith Healing and the Body

Tonight’s episode of House dealt with the idea of faith healing, something that comes up a lot these days in medical journals. What is the power of prayer? Does faith healing work? Can miracles happen?

I realize it’s a symptom of my interdisciplinary training, and perhaps of being under Phillip’s thumb in particular, but I think a more interesting question is why miracles can’t happen? After all, a miracle is just that which we don’t understand. As has been often remarked, our technically is magic to those who don’t understand how it works, as is often our medicine. The typical example is a cell phone in the rain forest, although I’d argue there’s an awful lot of technology and medicine that might as well be magic for our understanding – there is simply the belief, the faith that it will work, because someone is being told it will work.

How is that so different than hearing a faith healer tell you the same?

Of course, we of the rational, medical type say we have medicine, we can take the time to understand how technology works. But we can’t fully understand how the body works; we keep finding new things, miracles keep being rationalized and understood, filed away into things to learn and knowledge to distill.

If we have learned one thing, it’s that the body is an amazing thing. Who’s to say that the power of the placebo effect, the mind, isn’t enough to help some people? We know, scientifically, medically, that positive thinking does positively affect our health, including to help us recover from illness. Who knows?

We don’t, so it gets filed away as faith healing fakery and fraud. But in ten years, perhaps it will have a Latin name and a textbook. That’s the way knowledge goes, a part of life for both miracle and medicine.