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Maternity 1x03

Entry tags: episodes, reviews, season 1


I loved Maternity.  It revealed a lot about House, who he is and why, despite being a thorn in her side, Cuddy trusts his medical instincts better than anyone else's. 

House is an infectious disease specialist.  In Maternity, that background becomes obvious as he spots a epidemiologic cluster by observing two babies' illnesses.  House learns of the two sick babies in true House fashion. He is lazing in the OB/Gyn lounge, which has a high def television.  House has a small, old fashioned 13" portable in his office.  As House sits eating lemon jello, two docs come in, appearing to ignore and then become annoyed with House's presence, but one suspects that they knew he was there, would take the bait and jump on the case.  Their knowing smiles as House vanishes from the lounge signals that he's taken the bait.

House and Wilson observe babies in the NICU.  Wilson doesn't see the connection that House does.  Maybe House wants to see a connection because he's bored and an epidemic might be an interesting diversion, but it is his field.  House brings the two babies' cases to Cuddy, who believes that House has brought the cases to her because he wants to see a cluster.  She dismisses him, and House goes hunting for enough sick babies to support his hunch.

OK, I love the fact that the show has featured a lesbian couple, without fanfare, without drawing attention to it...just as a matter of course.  House doesn't make a snarky remark about it (in fact, given House's type of non-judgmentalism, it would have been out of character.  He is very much a  live-and-let-live sort of guy. Except that he doesn't easily suffer fools or hypocricy.  From patients or other doctors.  then he's plenty judgmental.  But he reserves his harshest judgments for himself.  Always (just not in public).


Judy: We were just going to call.

House: Did he get hot all of a sudden?

Judy: Yeah.

I loved that House got all concerned with that fake-sincere bedside manner. 

Cuddy finally gets the proof that it's a real cluster.  They have a hospital-borne infection.  Lots of liability for the hospital.  House's catching it probably, ultimately, saved the hospital millions of dollars in liabilty suits if all of those babies (and more) succumbed to the infection.

The fellows go and tell the parents of the affected babies.  Cameron shows that she has a hard time with this aspect of her job.  The job of any doctor not in pure research.  I actually liked the fact that they showed that not all doctors are great at giving bad news.  She is awkward, and Foreman has to jump in and cover for her.  This becomes a secondary plotline of not only this episode but of the first season.  We just don't know the "why" at this point.

Foreman: And I guess being the poor guy dying is toughest of all?

Cameron: [pause] No. It’s easier to die than to watch someone die. [She leaves Foreman standing at the front clinic desk.]

First clue that Cameron has had some personal experience along these lines.

Great clinic scene.  although I am all about the angst  ;), I love the clinic scenes for what they are: tension breakers, and a wonderful opportunity to watch Hugh Laurie's great and subtle comic skills at work--and that bone dry sense of humor and irony. 

House always has great disdain for the people who wander through the clinic.  He sees them as idiots and fools, that his talents are wasted on.  I don't know if he sees clinic duty as beneath him, but I do see it as an annoyance for him--it exposes him and his disability to casual onlookers--and at the same time, takes him away from his perceived "real" job -- his "mission" in a way of saving lives.  This particular clinic scene with the not-too-bright pregnant woman (dippy is a better descriptor for her, I guess) is hysterical and fits the title of the episode.

Jill: Can you do anything about it?

House: Only for about a month or so. After that it becomes illegal to remove, except in a couple of states. [He starts to ultrasound her abdomen.]

Jill: Illegal?

House: Don’t worry. Many women learn to embrace this parasite. They name it, dress it up in tiny clothes, arrange playdates with other parasites –

Jill: Playdates…

House: [shows her the ultrasound] It has your eyes. [It’s a baby!]

Jill: But… that’s impossible.

House: Well, I assume you weren’t getting your period. Maybe that should have give you an inkling.

Jill: But I’m on this birth control implant…

House: Yeah, I know. I saw the scar on your arm.

Jill: …and my doctor said I might not get any periods at all if it was working.

House: Mm hmm. Interestingly enough, you also don’t get any periods if it isn’t working, which is why you were supposed to get regular pregnancy tests. [Jill makes a pained face.] I’m going to send a nurse in here to schedule your prenatal care. You’re due in about five months, so start planning the shower.

The scene is too good not to put in here.

This leads us to a critical scene in House's office.  The antibiotics are affecting the babies' kidneys.  They can't keep them on both.  House tells them to take one baby of the Vancomycin and the other off the Aztreonam.  Foreman and Chase argue (esp. Foreman) that they can't do that.  They'd be condemning one of the babies to death.  It's a clinical trial, but the ethics are cold.  House (in front of the staff) appears confident and pretty cold-blooded about the whole thing.  It's rational and logical.  And they have no choice.

House continues this argement with Cuddy and the hospital attorney, who insists that House can't do it.  Not without the informed consent of the parents.  At first Cuddy agrees.  House doesn't argue that by doing it, he potentially saves the hospital millions in lawsuits if all six babies die of a hospital borne infection before the find the culprit.  It seems a heartless lose-lose situation for House, and, again,, he seems coldly logical and rational.  His affect suggests that he really doesn't care about the fact that he's condemning one baby to death.  But eventually Cuddy sees the terrible choice and tells House to "do what you think is best."  She isn't happy with the decision, but sees no way out.  Note that she doesn't say "do it."  She lays the choice --and the responsibility--completely on House.  It is evident here that Cuddy trusts House's instincts (wish she'd remember that more these days)--and knows that House is right, even though he puts it so clinically.  But she also lays the burden of the decision solely on his shoulders.  She can feel bad about her decision to trust House but the burden is all on him.

In the next scene, we see that House IS NOT unaffected by the decision he's making.  He sits at his desk (we don't know how long he's been sitting there, but I would think it's been awile).  He's having a hard time with this decision, despite his cold public demeanor.  This is what I love about House.  What makes him a classic hero.  He suffers his burden in silence and alone.  No one above him would help him with the decision; and he takes it on.  But here we see him suffer for it.  Alone.  It is not the light decision he would have other believe.  It is extremely hard.  But he flips the coin and the die is cast.

So the first baby dies.   It's a solemn moment and Cameron is intentionally assigned to break the news.  House wants her to deal with this.  She will need to if she wants to be a doctor in a real practice.  House is her teacher and needs to force her to deal with it.  Wilson runs interference when Cameron freezes up and House is ticked that he did. 

But now the other baby is dying too.  The team and wilson sit in House's outer office.  House rants my favorite rant--overprescribing antibiotics.  I was, at one time in a past career, a microbiologist.  One of the first things we learned in micro -- way back in the mid 70s was that doctors overprescribe antibiotics.  This causes resistant strains and superbugs, that can pass on resistance to other bugs.  I have never, ever let docs prescribe antibiotics to my kids for a regular cold.  Colds are viral.  Antibiotics do not work.  They only increase the world of superbugs.  I loved House's rant on it.

Abruptly, House sends everyone home for sleep.  He has an idea, one that (as we soon find out) will upset everyone else, and, again assumes the burden of doing it himself.  He needs to autopsy the baby to find out the real cause of death.  One of the things that House does extremely well and with tremendous delicacy are autopsy scenes.  They are almost always nearly reverent of the dead.  Watching House autopsy that baby is such an intimate exprience, you see the real House.  Unguarded, tragic, reverent of the task at hand.  Gone is the glibness and the coldness.  Even though he is dead, the baby gets respect from House, who takes the utmost care and speaks in sad, hushed tones for that very brief scene..

House discovers that its a virus.  And a great DDx scene ensues.  House in full professor mode--in charge of his precious white board and brainstorming.  Love it.  They figure out a way to figure it out, and when the results come in inconclusive, House realizes that the babies still have their moms' antibodies running their immune systems.  Duh.  So he alters the diagnostic path and figures it all out.  Babies saved.  House saves the hospital lots of money.

Final scene.  We see here how socially inept House really is.  He is clearly concerned about Cameron.  Yes, I know he thinks that something is preventing her from doing part of her job--something emotional that he needs to figure out.  But I don't think that's what this scene is about.  He really does want to connect with her here and find out why she had such a hard time.  His body language and tone of voice tell us this.  Even though his language tells us he's being a real jerk ultimately.  Is Cameron simply a puzzle to him to figure out?  Or is he trying to find a way to express his concern and just doing a real bad job of it?  Don't know the answer to that one, but my guess is the latter (with a bit of the former thrown in).

"nuff said.

Thanks to the "clinic_duty" LJ for putting up great transcripts.  makes this a whole lot easier.