EFL Movie Study Guide for:
House MD, pilot
(first show of season 1)
Introduction: I show medical students parts of this “first drama”
(i.e., premiere or pilot) of an American TV show to introduce the characters
and to facilitate a discussion on pain. In this episode, a young teacher
loses the ability to talk and then faints. Diagnosis is difficult. At first,
it is treated like a tumor, then vasculitis, and each treatment raises
questions that we can talk about after the show. (my version is 32 minutes)
Characters:
Dr. House: Head of Diagnostic Medicine
Dr. Cameron: one of three young doctors; the only female on
this team
Dr. Chase: the second young doctor; from Australia
Dr. Foreman: the third young doctor; an African-American
Dr. Wilson: a slightly older doctor (oncologist?), who is
also a friend of Dr. House
Note 1: This TV show uses a lot
of *sarcasm; that is, they say things that are the opposite of
what they mean, in order to make an unkind joke or to show that they are
annoyed.
Examples:
Dr. H says to Dr W: “You’re the renowned [famous] oncologist;
I’m just a lowly infectious-disease guy.” (Dr. H. really meant that his own
specialty was more important in this case than the other doctor’s
specialty.)
Dr. C: “Was she lying? Yes, the patient probably knew she was
allergic, and figured it was an easy way to get someone to cut a hole in her
throat.” (Dr C. meant that the patient wasn’t lying about her medical
condition, she just didn’t know she was allergic—and this almost killed
her.)
Dr. W: “Look into this case. Don’t leave all the fun for the
coroner.” (Dr W isn’t saying that it is “fun” for the coroner to determine
why the patient died, he is asking Dr H to get involved and hopefully to
prevent death.)
Note 2: At one point you hear them say that a worker
earns $8 per hour; in America this is not much! Just to talk to a doctor can
cost $100; many college textbooks also cost $75 to $100 (each).
*A few phrases:
to babble like a baby: to “talk” without making sense (“After taking the
medicine, she babbled like a baby for a minute before falling asleep.”)
change--“Do you have change for a dollar?” This means “please give me coins
instead of this dollar, so I can buy something from a machine that doesn’t
take paper money.”
“He’s a delinquent.” This means that, as a youth, he broke the law or did
socially unacceptable things.
“Good call.” This means “You made the right decision.”
intermittent problem: something that is sometimes wrong or bad, but
sometimes fine (“This muscle has an intermittent problem; three times last
week it hurt but most of the time it is OK.”)
to screw up: to make a mistake (see dialog 3)
to trigger a response: the trigger is the “button” you push to make a gun
fire, so this is talking about the situation or cause of a response or
reaction
to trust sb implicitly: to believe sb completely without doubt (“If I were
her student I would trust her implicitly.”)
Medical terms:
*allergy/allergic reaction: a condition that makes you ill (or gives you
skin problems, etc) because of contact with something your body can’t handle
(e.g., an insect bite, oil from some plants, chemicals in the air); when you
get sick because of an allergy it is called an “allergic reaction.”
aneurysm: when a blood vessel (or artery) is filled with too much blood
(esp. due to disease)
biopsy: the removal of cells from a body so that they can be examined for
disease
*CT/CT scan ( or CAT scan): a device (also process or result) that gives a
sectional (3-D) picture of the inside of someone’s body (I believe the
letters come from “Computed Tomography”)
coroner: an official whose job is to determine why sb died, using medical
tests
*diagnosis/diagnostic/diagnostician: the process and tests used to find out
what an illness is (diagnostic is an adj; a diagnostician is a
doctor with this specialty)
*genetic: related to the part of a cell that controls its characteristics or
development (遗传性)
HMO: Health Maintenance Organization--an medical organization that provides
health care to members under a group insurance plan (often without giving
patients many choices)
*hygiene: common practices (such as washing one’s hands and throwing out
trash) that make you and your environment clean, esp. to prevent illness
*the immune system: immune system: [c] the parts of your body that work
together to protect you from disease
*to inject (into a vein): to put (medicine) into the blood through a needle
lesion: damage to skin, brain, etc., caused by injury or sickness
MRI: Magnetic Resonance Imaging--a process that creates a picture of the
inside of your body, using strong magnetic fields (磁铁?)
*nerve: the “wires” inside your body that carry information to and from the
brain
neurocysticercosis: infection of the central nervous system due to tapeworms
neurologist: a doctor whose specialty is the body’s nervous system (network
of nerves)
oncology/oncologist: the study of tumors/a specialist in this field
*oxygen: an important element in our air (氧气)
*parasite: a plant or animal (e.g., a worm) that can’t live
except by being part of another plant or animal
*sanitary: (adj) describing something that is especially clean or free from
infection, bacteria or other unhealthy things; also called “hygienic”
seizure: a short, sudden loss of control of one’s body (often due to illness
or a negative reaction to drugs)
steroid: a chemical (or drug) that can fight illness or build muscles
*tumor: a useless mass of cells in your body that have multiplied too
quickly (some are dangerous and some are not)
vasculitis: inflammation of a blood vessel (in this story, it is in the
brain)
*to ventilate: to pump oxygen into a patient’s lungs
stroke: a serious medical condition when an artery in the brain bursts or
becomes blocked
ischemic syndrome or condition: related to a lack of blood (e.g., to the
brain or heart) because something is partially blocking the arteries
vascular: related to the tubing system that carries body fluids (esp. blood)
*Sentence pattern:
What happens when you give steroids to a person who has a
tapeworm?
What happens when you tell bad news to a person who is already
feeling bad?
What happens when you sell fake medicine to a person who is in
terrible pain?
What happens when you
______________ to a person who
______________?
Dialog 1:
Patient: Doctor, I still feel a lot of *fatigue. (i.e., he is tired a lot)
Dr: What are your other symptoms?
Patient: Headaches, mild fever, sometimes I can’t sleep, I have trouble
concentrating.
Dr: What medicine did your other doctor prescribe?
Patient: Vicodin.
Dr: That is very strong pain medicine.
Patient: I think I need a refill.
Dialog 2:
Dr. Chase: “You shouldn’t have told her this might cure her. It’s a long
shot guess.”
Dr. Cameron: “Perhaps, but I’ve given a dying woman a couple days’ hope.”
Dr. Chase: “False hope.”
Dr. Cameron: “If there was any other type of hope available I would have
given her that.”
Dialog 3:
Dr. House: “I don’t trust patients because everyone lies.”
Dr. Foreman: “Can we trust the blood test results from another hospital? I
assume it’s a corollary if ‘people lie’ that ‘people screw up’.”
Dr. House: “Right. Do the test over.”
Dr. Foreman: “Should we talk to the patient?”
Dr. House: “Yes. Everybody lies, but truth begins in lies.”
Dr. Smith: “The most important thing is not what people say. It’s what they
do.”
Dialog 4:
Patient: Doctor, how did the tests come out?
Dr: The protein markers for the three most prevalent brain cancers came up
negative, so you don’t have cancer. You are not responding to radiation
treatment, so it isn’t a tumor. The problem is a parasite.
Patient: Doc, I have decided that I don’t want any more treatments. I don’t
want any more experiments. I want to go home and die.
Dr: You’re being an idiot. You have a tapeworm in your brain. It’s not
pleasant, but if we don’t do anything you’ll be dead by the weekend.
Patient: Have you actually seen the worm?
Dr: When you’re all better, I’ll show you my diplomas. Patients always want
proof. We are not making cars here. We don’t give guarantees. But I’m pretty
sure about this.
Patient: You were sure I had vasculitis, too, and prescribed steroids—that
experiment failed. Now I can’t walk and I’m wearing a diaper. What’s this
treatment “gonna” (going to) do for me?
Dr: I’m not talking about a treatment. I’m talking about a cure. But it is
strong medicine. Possible side effects include abdominal pain, nausea,
headaches, dizziness, fever and hair loss..
Patient: What if you are wrong?
Dr. Because I might be wrong, you want to die?
Patient (after a pause): What made you a cripple?
Dr: I had an infarction.
Patient: A heart attack?
Dr: It’s what happens when blood flow is obstructed. If it’s in the heart
it’s a heart attack. If it’s in the lungs, it’s a pulmonary embolism. If
it’s in the brain it’s a stroke. I had it in my thigh muscles.
Patient: Wasn’t there something they could do?
Dr: There was plenty they could do, if they had made the right diagnosis.
But the only symptom was pain. Not many people get to experience muscle
death.
Patient: Did you think you were dying?
Dr: I hoped I was dying.
Patient: So you hide in your office and refuse to see patients…because you
don’t like the way people look at you.
Dr: People don’t want a sick doctor.
Patient: You feel cheated by life, so now you’re going to get even with the
world. But you want me to fight this. Why? What makes you think I’m
so much better than you?
Dr: What…you’re scared you’ll turn into me?
Patient: I just want to die with a little dignity.
Dr: There’s no such thing. Death is always ugly. We can live with dignity.
We can’t die with it.
Discussion:
Everyone work on these:
1. List the people who experienced “pain” in this show. What
do you do when you are in pain?
2. Tell your partner one thing you learned from this show,
either about medicine, English, or something else. Be ready to tell the
class what your partner says.
Key questions:
3. In this case (and most cases in this TV show), diagnosis
was very difficult. Why?
4. Dr. House told Dr. Foreman to break into the patient’s
house to look for medical clues. Do you think he should have asked the
patient for her key instead? Why or why not? Do you think Dr. Foreman should
have said “no”?
5. House said he had hired Foreman because he needed someone
with “street smarts.” What criteria should doctors use when they hire
others? Explain your answers.
6. Should people always try to get rid of pain, or can pain
be a good or “normal” thing?
7. What is a doctor’s responsibility in relation to the pain
his/her patient feels? Should the doctor deal with pain, or only deal with
illnesses and other problems?
8. Dialog 4 helps us see why Dr. House is always in pain. Can
you understand why he is often sarcastic, irritable and unhappy? Do you
think this behavior is acceptable? Explain.
9. If doctors earn a high salary, then medical care must be
expensive (patients must be rich, or insurance companies or the government
must pay a lot for health care). But some people can’t afford insurance or
expensive medical care. If doctors earn a lower salary, then more people can
afford medical care, and this lets the government (or medical/insurance
companies) spend more money on research. Talk about the good and bad aspects
of a high/low salary. Also talk about who should pay for medical care: the
patient, the patient’s workplace, insurance companies (can poor people
afford insurance?), local government, federal government, or someone else?
10. Once you are a doctor, would you rather work at a busy
public hospital or at an expensive private hospital? Explain your answer.
Extra questions:
11. Did you understand the sarcasm in this show? Dr. House
uses sarcasm a lot. Why? Do people use a similar form of speech when they
talk in Chinese?
12. At one point, Dr. House makes an educated guess about the
patient’s problem and starts treating it with steroids. Do you think this
was a good or bad decision? Explain.
13. Look at dialog
1. Is “fatigue” a kind of pain? What about the patient’s other
symptoms—are they “pain”? Explain.
14. Let’s think of pain as both physical and emotional. What
effect does pain have on the people in this show? Talk about each person:
Dr. Foreman—the pain of being hired for strange (and maybe prejudiced)
reasons; Dr. House—a constant physical pain in his thigh muscle; the main
patient—physical and emotional pain; the male patient—fatigue, headaches,
etc.
15. Can pain be an excuse for bad behavior? Should it be? Why
or why not?
16. At one point, the patient decided that she didn’t want
any more treatment (she just wanted to die). Are patients in China allowed
to make this kind of decision? What do you think about her attitude? What
would you say to her, if you were her doctor.
17. This show mentions an “HMO.” These organizations help
make medical care affordable in the US, but doctors don’t like them. Can you
guess why?
18. If there is a contradiction between your answers to
questions 9 and 10 (e.g., “the government should pay” but you want to work
at a private hospital), explain why.
Extra exercise:
Make up sentences with some of the phrases and medical terms
in this lesson.
Notes: These dialogs have been changed
for educational purposes. This isn’t a transcript of the show!
To understand some of the medical terms I looked at
http://www.nlm.nih.gov/medlineplus/mplusdictionary.html or
http://www2.merriam-webster.com/cgi-bin/mwmednlm
*I want students to learn these terms (i.e.,
all of
the phrases, plus a few medical terms)
