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Skin Deep (House)
Encyclopedia
"Skin Deep" is the thirteenth episode of the second season of House
, which premiered on the Fox
network on February 20, 2006. The episode aired in a special Monday night time slot.
), for heroin addiction and uncovers startling secrets about her. Meanwhile, Wilson hopes that House's increased leg pain indicates that his leg nerves are regenerating.
Before falling on the runway, Alex complains of nausea
, experiences double vision
and disorientation, and lashes out at a fellow model who tries to assist her. In the hospital, she begins to sweat profusely
. The team assumes that she is suffering from heroin withdrawal
, along with other hypotheses: juvenile multiple sclerosis
and Parkinson's syndrome. To confirm what is wrong, the team treat Alex with opioid antagonist
drugs and induce a coma
in order to relieve the extreme pain of this treatment.
While in the coma, Alex suffers from some sort of cardiac complication and afterwards displays anterograde amnesia
, or the inability to store new information in the long term memory. House is convinced that she is suffering from posttraumatic stress disorder resulting from sexual abuse from her father (Tom Verica
). To find the cause of the complication, the team conducts a lumbar puncture
which show protein levels in her cerebrospinal fluid
s. After being confronted by House, the father admits he had sex with Alex "one time".
House orders a brain biopsy
, which reveals no white matter
disease, leading the team to start focusing on the cerebral cortex
. House suggests paraneoplastic syndrome
, in which the body reacts against cancer
by making antibodies against the tumor which accidentally attack the person's own body instead, causing symptoms such as weakness, memory loss and problems with coordination, as such matching Alex's symptoms to an extent. After taking IV immunoglobulin
, which stops the antibodies, Alex stops twitching. As such, the team runs a series of tests, looking for a tumor, but finds none. The team is at a loss again.
When Cameron confronts Alex about denying her father's abuse, it turns out that Alex deliberately seduced him in order to get what she wanted. Cameron, disgusted, tries to tell Alex there are other ways to do things because she is so young. Alex tells her that she's not that smart but that she is that beautiful.
House finds the correct diagnosis when he is treating a clinic patient, a man with excess estrogen
having a sympathy pregnancy
for his wife. After getting an MRI of Alex's pelvic area, he determines that Alex has male pseudohermaphroditism
(specifically, androgen insensitivity syndrome
, also known as testicular feminization syndrome), and the tumor is located in her testes which, due to the syndrome, had never dropped. As the surgical removal of the tumor is set, a consult with a psychiatrist
is scheduled as well, for Alex to cope with the discovery of the complicated nature of her gender
.
House is also noted saying "the ultimate woman...is a man", alluding to the fact that Alex's condition allows only female hormones to be produced and allowing Alex to develop the desirable characteristics of women, such as large breasts and clear skin, and to the fact that she doesn't menstruate. This is also an ironic parallel to the condition of the clinic patient, whose wife complains that her husband is not helping her through labor due to his own "pregnancy". House had commented to her that "You've got yourself the perfect man - a woman."
At the end of the episode, House is seen in Cuddy's office asking to be given another injection of morphine
for his leg. Cuddy then reveals that her first dosage of morphine was actually saline
used as a placebo
, which shows that House's loss of pain in his leg was psychological. Later, at home, House plays his piano (the Allemande from Bach
's French Suite No. 5) in an attempt to ignore his desire to take his Vicodin. However, the pain is too much and he eventually swallows the pill.
House (TV series)
House is an American television medical drama that debuted on the Fox network on November 16, 2004. The show's central character is Dr. Gregory House , an unconventional and misanthropic medical genius who heads a team of diagnosticians at the fictional Princeton-Plainsboro Teaching Hospital in...
, which premiered on the Fox
Fox Broadcasting Company
Fox Broadcasting Company, commonly referred to as Fox Network or simply Fox , is an American commercial broadcasting television network owned by Fox Entertainment Group, part of Rupert Murdoch's News Corporation. Launched on October 9, 1986, Fox was the highest-rated broadcast network in the...
network on February 20, 2006. The episode aired in a special Monday night time slot.
Plot
Dr. House treats a teenage supermodel, Alex (Cameron RichardsonCameron Richardson
Cameron Richardson is an American actress and model, who portrayed Chloe Carter on the CBS television series Harper's Island.- Early life :Born in Baton Rouge, Louisiana, Cameron grew up in New Jersey....
), for heroin addiction and uncovers startling secrets about her. Meanwhile, Wilson hopes that House's increased leg pain indicates that his leg nerves are regenerating.
Before falling on the runway, Alex complains of nausea
Nausea
Nausea , is a sensation of unease and discomfort in the upper stomach with an involuntary urge to vomit. It often, but not always, precedes vomiting...
, experiences double vision
Diplopia
Diplopia, commonly known as double vision, is the simultaneous perception of two images of a single object that may be displaced horizontally, vertically, or diagonally in relation to each other...
and disorientation, and lashes out at a fellow model who tries to assist her. In the hospital, she begins to sweat profusely
Diaphoresis
Diaphoresis is excessive sweating commonly associated with shock and other medical emergency conditions.Diaphoretic is the state of perspiring profusely, or something that has the power to cause increased perspiration....
. The team assumes that she is suffering from heroin withdrawal
Withdrawal
Withdrawal can refer to any sort of separation, but is most commonly used to describe the group of symptoms that occurs upon the abrupt discontinuation/separation or a decrease in dosage of the intake of medications, recreational drugs, and alcohol...
, along with other hypotheses: juvenile multiple sclerosis
Multiple sclerosis
Multiple sclerosis is an inflammatory disease in which the fatty myelin sheaths around the axons of the brain and spinal cord are damaged, leading to demyelination and scarring as well as a broad spectrum of signs and symptoms...
and Parkinson's syndrome. To confirm what is wrong, the team treat Alex with opioid antagonist
Opioid antagonist
An opioid antagonist is a receptor antagonist that acts on opioid receptors.Naloxone and naltrexone are commonly used opioid antagonist drugs which are competitive antagonists that bind to the opioid receptors with higher affinity than agonists but do not activate the receptors...
drugs and induce a coma
Coma
In medicine, a coma is a state of unconsciousness, lasting more than 6 hours in which a person cannot be awakened, fails to respond normally to painful stimuli, light or sound, lacks a normal sleep-wake cycle and does not initiate voluntary actions. A person in a state of coma is described as...
in order to relieve the extreme pain of this treatment.
While in the coma, Alex suffers from some sort of cardiac complication and afterwards displays anterograde amnesia
Anterograde amnesia
Anterograde amnesia is a loss of the ability to create new memories after the event that caused the amnesia, leading to a partial or complete inability to recall the recent past, while long-term memories from before the event remain intact. This is in contrast to retrograde amnesia, where memories...
, or the inability to store new information in the long term memory. House is convinced that she is suffering from posttraumatic stress disorder resulting from sexual abuse from her father (Tom Verica
Tom Verica
Tom Verica is an American actor and director, known for his role of Jack Pryor on the NBC drama American Dreams. He played Astronaut Dick Gordon in the HBO miniseries From The Earth To The Moon...
). To find the cause of the complication, the team conducts a lumbar puncture
Lumbar puncture
A lumbar puncture is a diagnostic and at times therapeutic procedure that is performed in order to collect a sample of cerebrospinal fluid for biochemical, microbiological, and cytological analysis, or very rarely as a treatment to relieve increased intracranial pressure.-Indications:The...
which show protein levels in her cerebrospinal fluid
Cerebrospinal fluid
Cerebrospinal fluid , Liquor cerebrospinalis, is a clear, colorless, bodily fluid, that occupies the subarachnoid space and the ventricular system around and inside the brain and spinal cord...
s. After being confronted by House, the father admits he had sex with Alex "one time".
House orders a brain biopsy
Brain biopsy
Brain biopsy is the removal of a small piece of brain tissue for the diagnosis of abnormalities of the brain. It is used to diagnose Alzheimer's disease, tumors, infection, inflammation, and other brain disorders....
, which reveals no white matter
White matter
White matter is one of the two components of the central nervous system and consists mostly of myelinated axons. White matter tissue of the freshly cut brain appears pinkish white to the naked eye because myelin is composed largely of lipid tissue veined with capillaries. Its white color is due to...
disease, leading the team to start focusing on the cerebral cortex
Cerebral cortex
The cerebral cortex is a sheet of neural tissue that is outermost to the cerebrum of the mammalian brain. It plays a key role in memory, attention, perceptual awareness, thought, language, and consciousness. It is constituted of up to six horizontal layers, each of which has a different...
. House suggests paraneoplastic syndrome
Paraneoplastic syndrome
A paraneoplastic syndrome is a disease or symptom that is the consequence of the presence of cancer in the body, but is not due to the local presence of cancer cells. These phenomena are mediated by humoral factors excreted by tumor cells or by an immune response against the tumor...
, in which the body reacts against cancer
Cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...
by making antibodies against the tumor which accidentally attack the person's own body instead, causing symptoms such as weakness, memory loss and problems with coordination, as such matching Alex's symptoms to an extent. After taking IV immunoglobulin
Intravenous immunoglobulin
Intravenous immunoglobulin is a blood product administered intravenously. It contains the pooled IgG extracted from the plasma of over one thousand blood donors. IVIG's effects last between 2 weeks and 3 months...
, which stops the antibodies, Alex stops twitching. As such, the team runs a series of tests, looking for a tumor, but finds none. The team is at a loss again.
When Cameron confronts Alex about denying her father's abuse, it turns out that Alex deliberately seduced him in order to get what she wanted. Cameron, disgusted, tries to tell Alex there are other ways to do things because she is so young. Alex tells her that she's not that smart but that she is that beautiful.
House finds the correct diagnosis when he is treating a clinic patient, a man with excess estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...
having a sympathy pregnancy
Couvade
Couvade syndrome, also called sympathetic pregnancy or phantom pregnancy, is a condition in which a man experiences some of the same symptoms and behavior of an expectant mother. These most often include minor weight gain, altered hormone levels, morning nausea, and disturbed sleep patterns...
for his wife. After getting an MRI of Alex's pelvic area, he determines that Alex has male pseudohermaphroditism
Pseudohermaphroditism
Pseudohermaphroditism, or pseudo-hermaphroditism, is the condition in which an organism is born with secondary sex characteristics or a phenotype that is different from what would be expected on the basis of the gonadal tissue ....
(specifically, androgen insensitivity syndrome
Androgen insensitivity syndrome
Androgen insensitivity syndrome is a condition that results in the partial or complete inability of the cell to respond to androgens. The unresponsiveness of the cell to the presence of androgenic hormones can impair or prevent the masculinization of male genitalia in the developing fetus, as...
, also known as testicular feminization syndrome), and the tumor is located in her testes which, due to the syndrome, had never dropped. As the surgical removal of the tumor is set, a consult with a psychiatrist
Psychiatrist
A psychiatrist is a physician who specializes in the diagnosis and treatment of mental disorders. All psychiatrists are trained in diagnostic evaluation and in psychotherapy...
is scheduled as well, for Alex to cope with the discovery of the complicated nature of her gender
Gender
Gender is a range of characteristics used to distinguish between males and females, particularly in the cases of men and women and the masculine and feminine attributes assigned to them. Depending on the context, the discriminating characteristics vary from sex to social role to gender identity...
.
House is also noted saying "the ultimate woman...is a man", alluding to the fact that Alex's condition allows only female hormones to be produced and allowing Alex to develop the desirable characteristics of women, such as large breasts and clear skin, and to the fact that she doesn't menstruate. This is also an ironic parallel to the condition of the clinic patient, whose wife complains that her husband is not helping her through labor due to his own "pregnancy". House had commented to her that "You've got yourself the perfect man - a woman."
At the end of the episode, House is seen in Cuddy's office asking to be given another injection of morphine
Morphine
Morphine is a potent opiate analgesic medication and is considered to be the prototypical opioid. It was first isolated in 1804 by Friedrich Sertürner, first distributed by same in 1817, and first commercially sold by Merck in 1827, which at the time was a single small chemists' shop. It was more...
for his leg. Cuddy then reveals that her first dosage of morphine was actually saline
Saline (medicine)
In medicine, saline is a general term referring to a sterile solution of sodium chloride in water but is only sterile when it is to be placed intravenously, otherwise, a saline solution is a salt water solution...
used as a placebo
Placebo
A placebo is a simulated or otherwise medically ineffectual treatment for a disease or other medical condition intended to deceive the recipient...
, which shows that House's loss of pain in his leg was psychological. Later, at home, House plays his piano (the Allemande from Bach
Bạch
Bạch is a Vietnamese surname. The name is transliterated as Bai in Chinese and Baek, in Korean.Bach is the anglicized variation of the surname Bạch.-Notable people with the surname Bạch:* Bạch Liêu...
's French Suite No. 5) in an attempt to ignore his desire to take his Vicodin. However, the pain is too much and he eventually swallows the pill.
External links
- "Skin Deep" at Fox.com