Friday, February 08, 2008

A Real Life Case for "House, MD"

Dr. Gregory House is the main character of Fox's sitcom House MD. As most of you likely know, each week, he takes his, um, unorthodox approach, makes a few wild guesses, and generally solves some obscure medical mystery. What cracks me up the most about this show is that the entire hospital is apparently run by perhaps 7 doctors max, who are there all the time, do ALL the procedures AND all the lab work, yet still have time to randomly leave the hospital to investigate whatever random hypothesis they have. Anyway, this week, the NYTimes has a case made just for Greg House.

In the article A Medical Mystery Unfolds in Minnesota, the author describes a mysterious illness that has befallen some residents of a small town near Rochester, MN (home of the Mayo Clinic). What the residents had in common is that they all worked at the local meatpacking plant, the aptly named Quality Pork Processors. The patients had similar symptoms: "fatigue, pain, weakness, numbness and tingling in the legs and feet." The nurses at the meatpacking plant noticed the pattern. Doctors and officials in the plant contacted the Minnesota Department of Health as well as the CDC. The Department of Health decided to investigate. Here's what they found:

On Nov. 28, Dr. DeVries’s boss, Dr. Ruth Lynfield, the state epidemiologist, toured the plant. She and the owner, Kelly Wadding, paid special attention to the head table. Dr. Lynfield became transfixed by one procedure in particular, called “blowing brains.”

As each head reached the end of the table, a worker would insert a metal hose into the foramen magnum, the opening that the spinal cord passes through. High-pressure blasts of compressed air then turned the brain into a slurry that squirted out through the same hole in the skull, often spraying brain tissue around and splattering the hose operator in the process.

The brains were pooled, poured into 10-pound containers and shipped to be sold as food — mostly in China and Korea, where cooks stir-fry them, but also in some parts of the American South, where people like them scrambled up with eggs.

Okay, let's stop everything right here. I'm not even sure why this is a mystery anymore. The clues are staring me in the face. I'm no Sherlock Holmes, but just look at the evidence!

1. The place was called "QUALITY" Pork Processors. Come. On. Since when has the word "Quality" meant quality? Can you imagine buying another product.. oh say.. a car from a company called "Quality Car Company"? Anyway, so we've already established that sanitation is probably not Job #1 at QPP.

2. The process was called "Blowing Brains." Um, that by itself says enough. I mean, what else was on this assembly line? "Feces fling"? They might as well have had the workers just gnaw all the unnecessary parts off the carcass in terms of exposing them to whatever the pigs carried.

3. Blasting air into a hole with no other (significant) hole for it to escape from is a dumb idea. Period.

4. Spraying bits of brain matter is a dumb idea. Period.

5. To be fair, by itself, the spraying may not have necessarily caused disease, but:
The person blowing brains was separated from the other workers by a plexiglass shield that had enough space under it to allow the heads to ride through on a conveyor belt. There was also enough space for brain tissue to splatter nearby employees.

“You could see aerosolization of brain tissue,” Dr. Lynfield said.

The workers wore hard hats, gloves, lab coats and safety glasses, but many had bare arms, and none had masks or face shields to prevent swallowing or inhaling the mist of brain tissue.

So, basically, these workers might as well have been licking the insides of the skulls clean themselves. Genius.

Anyway, to make a long story short, once the workers were away from the plant, they recovered, but not fully. The disease (which sounds like some kind of mix between Guillain-Barre Syndrome and a prion disease to my still-in-training eye) was hypothesized to have been caused by an immune reaction the patients were having to the pig brain matter itself.

The real lesson here though?

Don't aerosolize dead animals!

In case you're not familiar with the show, you can purchase the season DVDs on Amazon: House MD: Seasons 1 through 4, or buy all 4 at once:




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2 comments:

  1. it is my favorite show. i Watch House MD online as i dont get time to watch it on tv and Hugh Laurie has done superb job as Dr. Gregory House

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