Cordial Deconstruction

As usual, an episode synopsis can be found over at Scott’s Polite Dissent.

Astrid Should Be Smarter Than That

I’d be a little more careful handling a large, unknown creature like that. Two people trying to hold the creature in their arms while one person tries to extract fluid with a syringe seems like a really bad idea. How about at least holding it down on a table, or better yet, restraining it on the table?

HDTV Prop Convenience Theater

The sticker on the air purifier in the woman’s house read:

MEDICAL AIR SYSTEMS

ULTRASONIC AIR PURIFIER

The sticker on the window read,

MEETS FDA STANDARDS

HERMETICALLY SEALED

CANZI MEDICAL GLASS MFG.

I’ll concede that it’s very plausible that the sticker would be on the window, but the air filter looks like it’s designed to blend in with the room and the sticker sticks out like a sore thumb. I call Prop Convenience Theater on the air purifier sticker.

No, That Means You Should See a Doctor Right Away

Conversation between Astrid and Walter.

Astrid:

“Walter, what if you’re infected with one of those worms?”

Walter:

“I’ve tested my blood and liver function; I’m fine.

In fact, my white cell count is through the roof. I have several new antibodies in my blood, and even the gas I had earlier is gone.”

First of all, it would be possible for Walter to have one or more worms implanted in him and them not yet be detectable; it’s only been a few hours since he was attacked.

Second, if his white blood count is “through the roof”, especially so soon after the bite, my first though would be a severe infection, probably even sepsis, and that he should seek emergency treatment immediately.

Two Different Shows Feature Helminthic Therapy Within Weeks of Each Other!

The November 17^th episode of House also featured treatment with parasitic worms.

Bad Medicine, Or This is Where I Try to Horn In On Scott’s Territory

Astrid explaining a picture on the computer screen:

“Ancylostoma Duodenale. An intestinal hookworm. It’s about 10mm long”

Walter:

“Chinese Medicine! Ancylostoma could be used for the treatment of chronic asthma. People are purposefully infected and walk around their entire lives with it.”

We’re good here so far. Helminthic therapy, treating someone by intentionally infecting them with parasitic worms, isn’t just “Chinese medicine”, it’s being investigated for use in scientific medicine.

But then the writers continue…

Walter:

“I believe it’s the parasite’s lymph gland that’s the real prize. It secretes a remarkable immune boosting enzyme.”

Peter:

“Immune boosting? So you might take that if you has, say a severe phobia of germs?”

Walter:

“Or if you wanted to treat any number of immune deficiency disorders.”

Except that as far as I can tell, only vertebrates have lymphatic systems, (hook worms are invertebrates), and that’s not how or why Helminthic therapy works.

Helminthic therapy is used for autoimmune diseases like Celiac and disorders of inflammation and over activity of the immune system like allergies and asthma. It is not used for immune deficiency disorders; the last thing you want to do with an immune compromised patient is intentionally introduce a parasitic infection. Minor infections that would normally not cause significant problems for a healthy individual such as cryptosporidium can be severe, lifelong chronic infections for immune compromised individuals.

It is believed that Helminthic therapy works by basically giving the body’s immune system something to focus its attention on so it stops attacking the body. It does not boost the immune system; that’s the last thing you want to do with autoimmune disorders, where the immune system is over aggressive and attacking the body.

Please see this excellent article by Dr. Mark Crislip, MD, an infectious disease specialist, regarding the concept of “boosting the immune system” and whether the it has any real meaning or if it would be a good idea if it was possible.

Saw it Coming a Mile Away

Hands up all those who didn’t figure it was the son with the germ problem right away. No hands? I didn’t think so.

Jitterbug Anyone?

Why hasn’t Peter given Walter a cell phone with important numbers programmed instead of a 3X5 card? Walter would probably so infatuated with the fancy gadget that he’d never forget he had it like he did that stupid card.

Question Better Addresses by a Someone Who’s a Doctor, Like Scott

If Astrid was knocked unconscious, would she be able to recall what happened to her immediately upon regaining consciousness? I seem to remember from several episodes of Medical Detectives and Forensics Files that generally that would not be the case.

Astrid Must Have Been in the Same Class at the Academy As Olivia

Astrid:

“I don’t know how they knew we had the worm”

Gee, all you and Walter did was mention a four foot hook worm to a Chinese shop keeper selling hook works, and the next thing you know, Chinese gang members are back at your lab stealing your giant hook worm. Go figure.

Peter Does Have a Death Wish

WTF was Peter thinking, going in there by himself? What, exactly, was his cunning plan, to take on an entire Chinese gang by himself?

As My College Lit Teacher Used to Say, “FORESHADOWING, PEOPLE- FORESHADOWING!”

Anyone want to bet that the tracking device in Walter’s neck becomes very important in a later episode?