Wilsons Heart Essay

Wilson’s Heart

“House” is a television medical drama that shows how House, a genius Doctor, leads a team of diagnosticians to solve the medical puzzle. I have watched every series of House, and among all of them, “Wilson’s Heart” is my favorite. Unlike the other episode, this one doesn’t have those mysterious and unfamiliar infections and rare disease, the problem was caused by the kidneys that I just learned in the Renal Physiology.

The story begins with House ran into a traffic accident. He remembered an important patient, but he then happens to have a serious concussion, which cause him lost the memory of what happened before the accident. After using phisostygmine to help him remember, House finally figures out the patient, Amber.

Amber is the House’s best friend—Wilson’s girlfriend and she was critically injured in the crash.

She completely damaged both kidneys in the accident and needs dialysis. She also has an elevated heart rate. House let Wilson pretends to be Amber’s husband to get her transferred to the hospital House works. On the ambulance, Amber falls into ventricular fibrillation. To avoid the possible brain damage by the chemicals released by the heart after defibrillation, Wilson convinces House to put Amber on heart-lung bypass so that House have enough time to figure out the problem and save Amber.

The first diagnosis for Amber is a congenital heart defect, an autoimmune disorder, blood clotting disorder and lead toxicity. However, both the angiogram and drug screen are negative while apartment searching turns out that Amber has some prescription diet pills. The diagnostic team thinks that the pills might damage Amber’s mitral valve, which leads to the heart problem she has. In order to confirm their conjecture, House decides to crack her chest open and stick a finger in the pulmonary artery to check the valve since she can’t do CT scan to confirm with a stopped

heart.
However, before the surgery, House notices that she has icteric eyes, which indicates that her liver is failing. House had several guesses, including antitrypsin deficiency, Hepatitis B. The biopsy seems to agree with Hepatitis B and she is then put on interferon. However, Amber then has red rash on her back while there are signs in the brain wave indicating the disease has spread to the brain.
House is still struggling to remember the missing memory of the night that is in question. He finally determines to undergo deep brain stimulation. During the procedure, House remembers Amber sneezing several times on the bus and complaining about the flu she has. He recalls Amber taking several pills. House suddenly realizes that her condition is cause by the pills she took, which are Amantadine for the flu. Since she damaged her kidneys during the car crash, the drug cannot be cleaned out and has built up to toxic levels, causing all the symptoms. Unfortunately, dialysis doesn’t work for clearing Amantadine which can binds to the proteins and Amber finally dies.
This film is related to the cardio system and renal system. It is fact that Amantadine is not abled to be cleared by dialysis. Also, there are deaths reported on the medication, according to my research. Although it seems incredibly convincing on the medical mystery, there are several mistakes in this episode that are different from what it is in reality.
First, heart-lung bypass and the hypothermia can’t work like that in reality. Instead, the bypass and hypothermia are designed for short-term use in the surgery.
Next, the mitral valve is not in the pulmonary vein.

As learned in the class, mitral valve is between the left atrium and ventricle. At beginning of the systemic loop, oxygen-rich blood enters the left atrium and while the chamber fills up, the mitral valve is pressed to open and blood flows into the left ventricle. When the ventricle contracts, blood push the aortic valve and exits the ventricle. The left ventricle and atrium experience the similar cycle. The only difference is that instead of having the mitral valve, the valve between the right atrium and right ventricle is the tricuspid valve, which has three flaps while mitral valve only has two flaps.

Also, instead of having aortic valve between the ventricle and the artery, the pulmonary valve lies between the right ventricle and the pulmonary trunk. Pulmonary valve and aortic valve are both semilunar valves, which has three cuplike leaflets that snap closed when blood attempting to flow back into the ventricles to fill them. Because of the shape of the semilunar valves, they do not have connective tendons as the AV valves do.

Finally, I doubt that deep brain stimulation could restore a target memory. So I did some research. Actually, the result of deep brain stimulation is somewhat random and even though you are trying to find the specific memory, it would need to take hours to get the right

memory.
If the writer was correct for the system in the series, it would make the story more credible and at least prevent misleading people to believe that the mitral valve is in the pulmonary. Also, the medical magic that always happens in the series definitely won’t happen in life. Including some explanation about the Renal system and how dialysis works may improve the physiological aspect of this film.
In general, although the film is somewhat spotty in medical and physiological aspect, I still like it as a character episode.