Despite Gregory House always it was never lupus, there was one episode of House, MD in which it really was lupus. The premise of the show made a weird medical drama trope actually make sense: House and his team dealt with the most difficult and strangest cases. This meant that a diagnosis was always incredibly difficult, there were false leads all over the place, and every episode ended with a rare or unusual disease. Since it was so hard, this led them down many blind alleys trying to find the right diagnosis.
One of the suggestions was always lupus, an autoimmune disease. It frequently came up as a possible diagnosis but never the actual one. Lupus is particularly difficult to diagnose, and despite being rare, it pops up all the time as a possible diagnosis for many underlying symptoms. Furthermore, Allison Cameron, who has a specialty in immunology, was the one who usually brought up lupus as a possible diagnosis, since that was the area she worked in most often. Overall, there were 30 cases in total that were suspected of being lupus, only one of which actually turned out to be correct.
In House season 4, episode 8, “You Don’t Want to Know”, it finally was lupus, paying off a joke that went throughout the first few seasons of the show. A magician, Flynn, suffered from a heart attack during a magic trick but didn’t show any signs of heart disease. They eventually determined that his lupus flared up, affecting his heart - a rare presentation, but finally an actual case of lupus on the show. When a blood transfusion went wrong, House realized that the blood test was showing antibodies it shouldn’t have, which led them to the lupus diagnosis.
What made this episode strange is that, while it paid off the lupus joke, the medicine in the rest of the episode was a mixed bag. The lupus diagnosis actually fit his symptoms pretty well, but the medicine, including what eventually led them to the diagnosis, was quite wrong. The team discovered the problem when giving Flynn a blood transfusion, which didn't match his negative blood type. In any situation requiring a transfusion, the doctors would test his blood themselves or use O- (universal donor) if there wasn’t enough time. It was a horrible misstep, compounded by House giving a bad explanation of how blood tests work. They did directly test blood cells, not just the antibodies, so that kind of flawed test just wouldn’t come back (via Polite Dissent).
While House, MD did finally have a case of lupus, it was such a strange one that it felt a little anticlimactic. “It’s never lupus” makes for a great joke, and while a time that it was lupus seemed inevitable, it would’ve been better suited to an episode that didn’t mess up the medicine in such a big way.
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April 10, 2020 at 09:49AM
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House MD: Why It's Never Lupus (And the One Time It Was) - Screen Rant
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