House Tackles Fat

No, not the House of Representatives...I'm talking about the Hugh Laurie drama series on Fox.

I don't usually watch TV. I haven't watched actual TV for several months, but last night I got to curl up on the couch in a pile of blankets to watch TV, the ice forming on the inside of the windows, the thermostat dipping below 25 degrees F (-4 Celsius) while I waited for the furnace repair people to show up and figure out why I had no heat.

The cats were not impressed.

Anyway, it was uncanny how the first TV show I've watched in so many months had a fat theme. Remind me to post my theories of synchronicity at some point. Better yet, go get Jung from the library :-)

Here's the summary from Fox:

When an obese 10-year-old girl presents with a heart attack, House and his team investigate. At first thinking it’s an adverse reaction to diet pills, they ultimately uncover a much more deadly source of her illness.

It's a re-run of course, and originally broadcast in 1995 (episode #116: "Heavy") And just to cover myself, I quote the episode a few times below, and would like to point out the obvious in that I do not own House, it is owned by Fox and NBC/Universal and they retain all rights. Any quotes are definitely unofficial and from an unofficial transcript by fans.

The summary is a bit misleading, since the diet pills theory came later in the episode. At first the only cause they focus on is the girl's weight. This episode is almost an expose' on fat bias in medical treatment, and a sad testament to why fat people often don't seek medical treatment, or suffer from misdiagnosis when doctors make assumptions. For example:

Chase: She’s morbidly obese. The “morbid” part of that raises alarms.
Foreman: Come on, it takes decades to eat your way into a heart attack.
Chase: Doesn’t take decades to kill yourself. If I was that fat, I’d be pretty tempted to knock back a bottle of pills.
Cameron: It’s not a drug overdose. The fatigue, muscle pain, and difficulty concentrating have been bothering her for over a year.
Chase: That’s because of her depression.
House: That’s what five pediatricians, two nutritionists, and a psychologist said. The heart attack would seem to indicate that they missed something.
Foreman: It’s got to be something genetic.
Cameron: What about Metabolic Syndrome X?
Chase: Insulin resistance?
Foreman: Syndrome X could cause a stroke, but I don’t know about a heart attack.
House: Could, if her blood pressure was high enough.
Cameron: Which is likely, considering her weight.

Personally? I have very low blood pressure. The doctors go with this (wrong) diagnosis and subject the girl to a dangerous testing procedure that exacerbated her condition, causing an open staph infection. The only thing that gets the doctors to see past their weight bias is the mother's willingness to fight for her daughter:

Mom: She’s diabetic?
Cameron: No, but it’s similar. MSX patients don’t respond normally to insulin, which causes her body to create too much, which causes metabolic abnormalities. We’re going to do a test to be sure, but there are certain dangers.
Mom: Is this thing treatable?
Cameron: It’s controllable through proper diet and exercise.
Mom: Wait. Jessica already eats right. And she exercises every day!
Cameron: I know you’ve already seen several nutritionists –
Mom: And we’ve done everything they recommended.
Cameron: I understand, but –
Mom: Why can’t any of you doctors see past her weight? If diet and exercise are the treatment, then the diagnosis is wrong.

Go Mom! Unfortunately, while Dr. Cameron starts to learn empathy, Dr. Chase continues his fat hatred throughout the episode:

Chase: Obesity isn’t something you just grow out of.
...
Foreman: And you figure making her feel like crap would do her a world of good?
Chase: Yeah, if it gets her off the couch!
Cameron: I’m sure she’s already under enough pressure.
Chase: Enough from mummy?
Cameron: Everything in society tells us we have to be thin to be successful.
Chase: No, society tells you you have to be thin to be attractive. And guess what, that’s what attractive means: that society likes looking at you.
Cameron: I think we should be telling our kids it’s fine as long as they’re healthy.
Chase: All right. You weigh 90 pounds because it makes you healthier?

Then:

Cameron: Right, because anything's possible, but nothing's going to cause multiple clots in a kid this age.
Chase: She’s fat!
Cameron: Obesity doesn’t cause blood clots.

Then House, who at least seems to hate everyone, so the reaction is typical and somehow less offensive.

House: But what about some other ridiculous obesity treatment?
Foreman: Like what?
House: Diet pills can cause heart attacks and blood clots.
Cameron: Her tox screen was negative.
House: Wouldn’t show over-the-counter weight loss drugs.
Cameron: Her mother wouldn’t give her diet pills.
Chase: [sarcastically] Yeah, she thinks her daughter’s perfect just the way she is.
House: She’s lying.

Because a parent couldn't possibly be happy and proud of a fat daughter. Cut to the school, where Dr. Foreman is interviewing the friendless girl's assigned 8th grade "buddy"

Clementine: All she does during recess is run laps around the playground. She says she’s exercising, but everyone knows it’s just because no one wants to play with her. I mean, I’m only her buddy because Ms. Ayers assigned her to me. That does not mean I am her friend.
...
Clementine: I totally busted her for taking drugs one day. She totally lied, said they were diet pills her mom had given her. Come on, get real. No way a girl like that is taking diet pills.


And another fine example of fat hatred from Dr. Chase:

Chase: Right, so I guess it’s the media and pharmaceutical companies’ fault now?...Not the fact that she can’t stop shoving food down her throat. No one forced her to get fat.
Cameron: No one forced a cancer patient to get cancer.
Chase: Give me a break, it’s not a disease.
Foreman: Have you seen the latest research?
Chase: Yes, I have. What I haven’t seen lately is a kid eating an apple or riding a bike. You Americans can’t even compete with the rest of the world in basketball anymore, unless, of course, it’s the type you play with a remote control on a big screen TV.

And a clean miss on the fact that the girl ran laps every day...and that her diet was controlled by a nutritionist.


To wrap it up, the girl develops a staph infection and open lesions from their treatment and only when her life is at risk do they manage to get past her weight as a cause (and leap right to it as a symptom...why does it have to be related at all?) They find a tumor on her pituitary that is stunting her growth, causing her other symptoms, and making her fat.

So in this case, despite the excellent examples of fat-phobia, bias, hatred, and myth-busting, fat is still a "disease" and something to be "fixed" by the crack (or cracked?) doctors. The episode finishes off with the now taller and thinner "fixed" girl smiling for the first time in the episode.

A secondary story line is around a fat woman who comes in for heartburn. House misdiagnoses her as pregnant, despite the fact that her husband had a vasectomy and they use condoms. Even though the character is portrayed as stupid, there's some great quotes.

Lucille: Okay. [She hops off the table and gestures to herself.] This is what a woman is supposed to look like. Okay, we’re not just skin and bones. We have flesh. We have curves.
House: You have little people inside you. [Lucille grabs her purse and heads to the door.] Okay, okay, I’m sorry. I guess I must have just been brainwashed by the media, and all those years of medical training.

Later they discover that she has a record-breaking 30 pound benign tumor on her ovary. Talk about misdiagnosis. Even though the tumor is completely benign, they still assume she'll want surgery to remove it since it would also give her a flatter belly. They're shocked when she disagrees.

Lucille: I’ll have a huge scar! I won’t be able to wear a bikini!
House: You wear a bikini now?
Lucille: Yeah, you got a problem with that?
House: Nope, but I’ve never gone swimming with you.
Lucille: I knew it. That’s what this is all about! You are trying to force me to have cosmetic surgery!
House: Yeah, that’s exactly why I planted a thirty pound tumor on your ovary.
Lucille: It’s not gonna kill me. [House and Wilson share a “are you hearing what I’m hearing?” kind of look.] The only thing surgery is going to do is change the way I look. That is the definition of “cosmetic surgery”.

Woohoo! Point set match for the fat chick! Later the husband manages to convince the disbelieving Dr. House that he DOES actually like his wife's body, but convinces her to have the surgery out of fear of health complications from the tumor (which was causing her heartburn).

Ok, so that's the episode. And I can only justify such a long post about a re-run TV episode by the conflicting impressions about it. There was such a mix of sizism and size-positive in the episode that I could find something to love and hate in every scene. On the positive side it did a very good job in portraying fat bias in medicine and society. The fat hating characters actually come across as mean-spirited, ignorant and irrational, which is pretty unique in a medical show. On the other hand, the fat-positive message falls a little short. The gutsy fat chick with the tumor is portrayed as stupid and delusional, pretty much a slightly more sophisticated fat joke than usual. The fat girl shows the incredible dehumanizing treatment of fat children, but her weight is still a disease to be "fixed" instead of simply acknowledging that someone can be genetically fat despite a healthy lifestyle. The fact that it IS "fixed" in the end reinforces that mixed message. Plus there's a bit of ethnocentrism thrown in for fun, since the most vocal fat-hating doctor is Australian, and he's the only one who doesn't learn compassion or make progress towards actual size acceptance in the course of the episode. Or could it be a class-based comment, since he's also the only independently wealthy character? Hard to tell.