Clinic Case: Odoriferous Passage
[House walks into the exam room, where he sees a
teenage girl who is looking very embarrassed.]
House: Is there any
particular reason you haven’t filled out the patient history forms?
Girl: My
parents are Christian Scientists and would rather have me sit at home praying
instead of seeing a doctor. If they find
out I’m here, I’ll get in big trouble.
House: And
if the medical licensing board finds out I’m treating a minor when I’ve been
told that it’s against the parents’ wishes, they’ll take away my Nintendo and
ground me for a week! [Starts to leave]
Girl: Please, I talked
to the nurse about my problem, and she said she thought it might be OK just
this once. I also asked for a woman
doctor and she said that you were the only one around here to break rules like
not filling out forms and stuff. Please
. . . [she looks at him with very
pleading puppy-dog like eyes]
House: Well,
as long as there’s no paperwork and you understand that I’m not actually
treating you, then let’s start with why you’re here, and I’ll see if I can
help. What’s going on?
Girl: My um, . . . my uh . . .
House: [rolls his eyes] Listen,
I can understand not filling out paperwork, but you have to be able to tell me
what the symptoms are in order for me to diagnose your problem. Can you at least point to what’s wrong?
Girl: [shakes head; leans toward him and whispers] My pee smells really
bad.
House: [Gets a very serious and overly concerned
look on his face] I see, and how long has this
been going on? [Takes her chin in his hand, and examines her face on both sides, up
and down.]
Girl: [Whispering] My problem is [whispers and points] down there, not on
my face!
House:
Yeah, I got that. [lets go of her face, looks at her] How long?
Girl: Um, about two
weeks. I talked to some girls at school,
and they said to look it up on the internet.
But my parents think the Internet is the devils’ work so I don’t get to
look at it from home or at even at school.
So I asked my boyfriend to look it up for me. [Pause,
looking for a sign of approval, which she doesn’t get] He—He said it might be an OOTIE.
House: [puzzled expression] An
OOTIE?
Girl: Yeah,
some kind of infection -- down there.
House: Uh
hah. An OOTIE. Were you born in
Girl: What? No.
House: Then
it’s fairly safe to say that you don’t have a Canadian bellybutton. Perhaps your boyfriend was referring to a
Girl: Oh,
yeah, maybe that’s it.
House: [Shoots these questions in rapid fire at
her; girl responds to all of them with shakes of her head or negative “uh uh”s] Do you have any itching -- down
there? Any burning when you pee? Trouble making it to the bathroom in
time? Wetting your panties when its only just a little bit funny instead of a lot lot lot funny?
Girl: No,
none of those things.
House: Then
it’s not a UTI. Here, I’m going to write
out some simple instructions for you to follow.
I’m not even going to put them on prescription paper, because it’s not medication,
it’s really just a change in diet, so your mommy and daddy can pray over the
food all they want and not get all in a tizzy about it. [Grabs a
blank notepad and scribbles away.]
Girl: [reading] Follow strict diet regimen for
14 days. Saturday through Thursday, eat
two servings of asparagus, one with breakfast and one with lunch. Friday no asparagus, fish for lunch and sea
scallops for dinner. [She pauses and looks up at him with a big
smile] Are you serious? That’s all I
have to do? [she’s relieved that the instructions are so
simple] This diet will make my pee
stop smelling bad?
House: Weeeelllll, I can guarantee you that it definitely won’t smell like it did before. But you have to be careful and follow these exact instructions, or else it won’t work right. By the time you’re done following them, we should pretty much have two problems covered. For one, you’ll have a much better appreciation for the phrase, “What goes in must come out.” Two, it’ll makes an excellent repellant for stupid boyfriends. Sorry I haven’t got anything that works quite as effectively on stupid parents. But as an added bonus, if you’re really really smart, you just might figure out that you should stop taking someone else’s acne medication.
[practically shoves
her out the door]
Girl: How did you know I –
House: Because you have fairly recent scars on your face from severe acne. Yet you have clear skin now. And you won’t see a doctor, so you didn’t get a prescription for amoxicillin, but profusely pungent pee means you’re taking it. If you’re consulting with the boyfriend on the stinky pee problem, then you probably figure it’s also safe to mooch off his prescriptions. [Pause] And while you’re at it, you might want to see if he’s got any vicodin before he dumps you, I’ve heard a rumor that it’s great stuff.
[really shoves her
out the door]