Let's Talk Now of Diagnosis
(To the tune of "Never Mind the Why and Wherefore" from Gilbert and Sullivan's H.M.S. Pinafore.)
Scene: House throws several copies of a patient file onto the conference table before Fellows 1.0 and commences.
HOUSE:
Let's talk now of diagnosis—
Is it parasite? Thrombosis?
For the patient in that file
Is revolving round the drain.
Now someone volunteer. I'll
Remind you to use your brain!
So inform me: what's the ailment
Plaguing patient-of-the-week?
What disease caused this assailment?
You're fired if you don't speak!
Differential diagnosis!
FELLOWS:
Differential diagnosis!
HOUSE:
It's the routine: if you know this
Propose a damn diagnosis!
FOREMAN:
Possibly it's in his brainstem—
Tumor could those symptoms cause.
In his body, dire mayhem—
HOUSE:
But your theory has some flaws!
In the nervous system central
(Within skull and dorsoventral)
You will note some mechanisms
That have not yet suffered harm,
Which they would have, if a tumor
Had moved in in all its charm!
You and central nervous system:
Won't you leave that stupid box?
Specialty disorders—list 'em—
Serve as diagnostic blocks!
Not the central nervous system!
CHASE/CAMERON:
Not the central nervous system!
HOUSE (tersely):
Screw the central nervous system,
And give me another system!
CAMERON:
Autoimmune: that could do this,
Make his body harm itself.
Steroid treatment; he'll live through this,
And this case we all can shelf.
HOUSE:
Just told Foreman, 'Be creative,
Give me something innovative!'
So 'It's immune,' you blithely think,
But the tests that thought negate!
Someone better these symptoms link,
Or it's gonna be too late.
CHASE:
Approach from the wrong direction:
Symptom two was symptom one.
The subsequent imperfection—
HOUSE (satisfied):
There, see? That is how it's done.
Just a little innovation.
FOREMAN/CAMERON (resentful):
Just a little innovation.
CHASE:
And a little validation?
HOUSE:
Watch me glare exasperation.
Differential diagnoses:
All our patients' problems solved.
(And to fellows with neuroses—
Beware: I might get involved!)
FELLOWS:
Differential diagnoses:
All our patients' problems solved,
From their cancers to psychoses—
Nothing less, with House involved!