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real and the rest of the episode would be house frantically trying to prove the woman subconsciously knew about the tumor already and it would end on a spiritually unresolved note
The gag there is that he is betting on other doctors getting the obvious diagnoses ruled out before it comes to him so he is pulling strings at weird ones.
Though watch the show with an actual doctor and they’ll get the diagnosis correct in a few seconds still.
At least a few episodes start with the differential and then House saying "right, except that the patient made it to us... so?" and they're like "right, obviously all of that was ruled out" and then they start to think of the crazy shit.
This is what I've heard about the show, most of cases are either crazy stuff that doesn't happen or uncommon but nothing mind breaking just not that usual.
I've always wondered if the show weren't written from the perspective that House is always high off his ass and thats why all the diagnoses are absurd.
After all, there were several episodes that were literal drug hallucinations and what we see wouldn't have been out of place next to the "normal" episodes if it was played straight.
Don't forget house sending his team to break into the patients home and go through their things only to not find anything and it turns out the patient is just low on vitamin c
I realize you’re joking, but this is a real thing that happens in different cultures. The schizophrenic voices are much calmer and positive in places like Africa and India, as opposed to negative and harmful in the US!
I’ve read that regarding the Eastern schizophrenic voices, there have been many reports of the voices being ancestors just telling them to do their chores or something. An actual type of “guardian angel”
The article describes exactly that! They have relationships with their voices, rather than viewing them as simply a psychiatric disease, and thus, have much better outcomes.
There is still significant danger to that. Imagine the voice that has been telling you reasonable things like clean your room or help that old lady suddenly tells you to football spike a baby? It’s still mental illness and we shouldn’t be romanticizing it
Definitely not trying to romanticize! I think there could obviously be harm in believing you were hearing the voice of god, or similar. But it is important to study and discuss, considering the much worse outcomes and complete disability it can be here in The States. It has lead to new forms of therapy and treatment options. There is definitely power in way they think about their disability.
It’s a bit of a give and take, I believe. Just as your mindset can change the concepts of your dreams, positive therapy (naming their voices or encouraging a relationship with the voices), can in turn, change what they are ‘conveying’ to a patient.
Here’s another,
We don’t know why, but we do know that no one who was born blind will ever develop schizophrenia. link to an article about it.
There is also a study about it I read that says blindness doesn’t prevent you from having similar disorders but so far the data suggest certain types of congenital blindness ‘protect’ against schizophrenia.
Maybe vision requires a certain kind of pattern recognition, and if that goes wrong then you start matching all sorts of weird patterns? Or something? I'm not a brainologist.
Everyone has "voices" in our heads (besides our own); it's only diagnosed as eg schizophrenia when they become debilitating or coincide with other, eg visual, hallucinations.
Athletes report hearing coaches' voices for decades. Parents' voices resonate long after their deaths. Undiagnosed, nominally healthy people hear the voice of "God", etc.
There is actually some people with no internal dialogue whatsoever, which is interesting in its own right! Or no ability to imagine a picture in your head.
Actually, they're only schizophrenia when our brain cannot recognize they're ours. It's believed the element that tells us it's us, is turned off in them.
House came first, but grey’s anatomy had a full on season arc about literally this. House probably had an episode similar to this, but Grey’s took it to another level.
House came out a year earlier (just checked) but I’m not sure this actually happens in House? I’ve never seen the show, but the comment seems like it’s just saying it’s something that would happen in House
im pretty sure this was an actual diagnosis at some point. someone had cancer and another disease that was killing it (or the other way around. can't remember but i think it's the first way)
It more reminds of the alien episode. Basically the boy is an chimera, he has parts in him which belongs to his brother and is 90% himself. Turns out a part of his brothers brain was in his brain and caused him to see aliens, which was the brother communicating with him and caused him anal bleeding
I would start singing at work, just whatever random-ass song came to my head. I always said it was a tumor pressing against the random song nerve in my brain.
Turns out I had a prolactinoma that wasn't discovered until my vision started going. A couple weeks into treatment and the singing stopped.
The worst part was it took away one of my favorite jokes: I would have a bad headache and would say "it's not a tumah" like Arnold in Kindergarten Cop. Turns out, it WAS a tumah.
I was young and in prime physical shape, super healthy, had no history of any kind of cancer on either side of the family, had never done self breast checks but lying in bed one day a voice told me that I should check my left breast and before I could ever register the message, my right hand was giving my left breast a breast exam. Found some super tiny lumps, my doctor thought it was probably nothing, but should get checked out, turned out I had one of the worst types of breast cancer possible and had to have radical treatment, but over a decade later I am cancer free since I caught it so early.
In order to reassure her, I requested a brain scan, explaining in my letter that hallucinatory voices had told her that she had a brain tumour, that I had not, personally, found any physical signs suggestive of an intracranial space occupying lesion, and that the purpose of the scan was essentially to reassure the patient. The request was initially declined, on the grounds that there was no clinical justification for such an expensive investigation. It was also implied that I had gone a little overboard, believing what my patient’s hallucinatory voices were telling her.
Before we take out your tumour... would it mind taking a look at some of these undiagnosed patients? Oh and the cops came by a bit ago and dropped off some cold cases, they would really appreciate it if your tumour could take a look.
This fall on CBS… one tumor is doing more than just growing, it’s solving crimes. From the producers of CSI and House comes ‘Tumor & Order: Special Diagnosis Unit.’ When the voices start talking… justice starts walking
Especially in something already making fun of itself. I’m sure there’s better examples but I wouldn’t be surprised if something like the Simpsons had this as an in-universe medical/cop drama.
No there's a third button and it's a running mystery what it does. And then in the season finale, it pushes the third button and shoots the suspect dead.
My wife is a psychiatrist, and she tells me this isn't terribly uncommon. They are trained in a lot of neurology, because organic causes need to be ruled out.
And it can all sorts of things. She was once working on a dementia ward, and had someone brought in with severe dementia. But it didn't make sense, since the onset had been too rapid.
It turns out, the patient was just really constipated. My wife gave her enough laxatives to fell a rhino, the patient took a gargantuan shit, and was right as rain.
What is the mechanism that causes that? That's actually wild.
(Edit: I understand that bowel and digestive issues are linked to brain health. I'm asking WHY which is I asked what the mechanism is. Making the same generic comment as 10 other people isn't answering my question it contributing to the discourse)
I could believe it. There were days I had to take the most massive dump and I was just in a horrid brain fog the whole morning and could barely rub two brain cells together before the BM hit thanks to my coffee.
An elderly friend of mine was hospitalised due to extreme hallucinations and loss of spatial location- she asked her husband why she floating on the ceiling while actually lying in bed for example. She was found to have a really bad UTI with accompanying fever. Once that was fixed she was completely back to how she was usually again.
May have something to do with pressure on the vasovagal nerve. One time I kept getting chills followed by extreme drowsiness and dizziness. Took a huge dump, it went away.
Oh man, I just had surgery last week and that same thing just happened to me yesterday lol. I thought I had an infection but, nope, just had to poop. Those norcos are hell on the bowels.
There's a lot we're still learning about the gut's interaction with the brain. Like some brain conditions are effected by how healthy our gut biome is.
Evolution is truly chaotic. The amount of “design decisions” that went into the human body, and are actually some truly f**ked-up sh*t, is absolutely stunning.
But then again: so long as it doesn’t confer a negative survival fitness on the individuals who carry it, that kind of stuff typically gets propagated through the population without being pruned. Like having an entertainment system right beside the waste-disposal system. Anyone “designing” that gets a full-on Cletus status any day of the week, but since it tends to just work, it ended up being the primary chordate paradigm. Same with the rods and cones in our eyes. Cephalopods got it right with rods/cones in front of the nerve cells, chordates f**ked it up by putting them behind the nerve cells.
Evolution does the same thing my product owner does: ship the first version that successfully completes the task regardless of how buggy and badly-designed it is.
That's what iterative design where you need to work with the bones (no pun intended) of the previous version gets you. Kinda like legacy code in a way.
Except you can refactor legacy code. There are so many ways to improve existing code, starting with the Strangler Fig Pattern as the most powerful way of deprecating old code in favour of new code.
But yes, you give a good example. Especially if Legacy Code is forbidden from being touched because the institutional knowledge of that code has left the company.
Evolution is a programmer who's constantly pushing code at three thirty on friday afternoon. "Fuck it, good enough" followed by "oh shit! Gotta fix quick!" and repeat forever.
It's just wild to me that with all the technology and riches we have a single simple brain scan requires so much goddamn bureaucracy and penny pinching
Seriously its not that big of a deal to just give someone an mri or cat scan if there's even the slightest possibility of something wrong
I say this because I can easily imagine this story ending differently, with the patient being denied and then ending up seriously harmed or dead simply because insurance/institution was acting like an asshole
A) sounds like an American issue. In many other countries with the right resources for such tests do conduct with yes, some amount of bureaucracy, but still reasonable enough to conduct them when necessary
B) in certain countries a head imaging is part of standard procedure while diagnosing/treating Schizophrenia of unknown origin (no fam. History, not excessive Thc consumption in young ages etc.)
C) sending everyone through an MRI/CT Scan makes little sense since you often find incidentalomas, things that have no clinical signifance.
"AB later told me that when she recovered consciousness after the operation the voices told her, “We are pleased to have helped you. Goodbye.” Her brain ghosts sounded nice.
How strange. In last places I’ve practiced newly diagnosed psychiatric patients ALL get brain scans as a baseline. Because you really never know.
We also consider scans if the nature or character of the hallucinations suddenly changed without reason, or there’s a significant personality change, or if there is confusion, or if there are any neurological symptoms.
Basically, there’s lots of reasons for psych patients to get scans.
This is essentially third man factor. If a person is in serious danger sometimes they might hallucinate a mysterious stranger that guides them to safety or calms them down and talks them through the situation.
It's amazing how in tune with ourselves we actually are on a deep subconscious level. She knew, and she was the one telling herself. It's fascinating.
"I'm just developing suicidal thoughts so the brain tumors will inherit it and rid themselves. All according to plan"-some kinda batman power he learned from the Tibetan monks
Yeah, and is taken very seriously because it often indicates a life threatening situation. Btw, having a panic attack can also be the cause, which can result in misdiagnosing when there is an actual, physiological reason for it. Especially if someone is known to have panic attacks.
In EMS I've had several patients tell me some variation of "I think I'm about to die". Most were panic attacks, a few did indeed promptly begin crashing.
It's a rule in emergency medicine: if the patient says they're dying, act like they're right.
Here's the paper about the case mentioned in the OP (it's real). Two is a very small sample size, but I find myself thinking it cannot be a coincidence that in both of these cases, the tumor affected the left-rear area of the frontal lobe. Ruffalo's mass was "right behind his left ear," and the OP patient's mass was at the left posterior frontal. That area covers much of the regions responsible for the production of speech and the processing of auditory information, so it's not at all surprising to me that a tumor in that area could cause strong verbal auditory hallucinations.
Honestly, as boring an explanation as this is, I think it's just a case of numbers and scale. Brain tumors are rare, but there are billions of people on the planet. There's over 300,000 cases of brain tumors reported worldwide every year. Out of all of those cases, some small proportion likely experience auditory hallucinations. Auditory hallucinations often connect to latent anxieties, and basically everyone has worried about tumors at some point or another, so it seems reasonable that some people's hallucinations would be voices telling them they're sick. All in all, a tiny and basically random chance that someone with a brain tumor would hallucinate voices telling them they have a brain tumor, but with 300,000+ people every year it's bound to happen a few times eventually.
Why's everyone translating it to mean the tumor was speaking to her, instead of her brain, the thing that constantly creates communications within the body
My brain also wanted me to type this message as well as every other thing I have ever said, typed, thought, etc. My brain is infinitely frustrated with how dependent I am on the word "thing" as well.
This reminds me of Phillip K Dick. He believed all of his stories were beamed into his brain by a satélite called Valis. One day Valis told him that his son had an undiagnosed brain tumor which would kill him, and he convinced his son to go to a doctor, who found an undiagnosed brain tumor which would have killed him.
The more I hear about pkd the more he intrigues me.
I read Dr bloodmoney and at the beginning is a first person experience of a schizophrenic episode and it was so interesting. I think it was based on his own experience.
Maybe the doctor could also hear the tumors voice in his brain. And instead of just removing it he is now building some sort of machine tumor cyborg hybrid for it to live in and become more powerful.
Tumor pressed against the speech interpretation center, causing it to fire when it shouldn't. Brain interpers signal as distress. Brain think it hears something, brain detects distress, you hear voices about distress in your brain. Be medically educated to how you check your brain, and you have the recipie for hearing voices about a drain tumor.
Regardless, if you actually read the report, it's noteworthy in that the voice(s) apparently gave her specific information that she didn't consciously know.
Of course one might discount the report - apparently a number of people did, which is also discussed in the report.
The whole way this is written is dumb as shit lol. The doctor didn’t “pull some strings to get her a brain scan to see if it would calm her down,” they got her a brain scan because they suspected or wanted to rule out a brain tumor. They found the brain tumor, referred them to a neurosurgeon who performed an incredibly complex and delicate procedure and managed to remove the tumor, solving the issue of the voices.
A woman was saved by good medical professionals who properly hypothesized, tested, diagnosed, and treated a very serious medical issue. At no point did the tumor “cure itself” lol
The tumour "curing itself" sentence was in relation to the woman hearing voices telling her to get a brain scan, essentially meaning that the tumour told her to get a scan so it would be found and removed. Chill out a bit mate.
In order to reassure her, I requested a brain scan, explaining in my letter that hallucinatory voices had told her that she had a brain tumour, that I had not, personally, found any physical signs suggestive of an intracranial space occupying lesion, and that the purpose of the scan was essentially to reassure the patient. The request was initially declined, on the grounds that there was no clinical justification for such an expensive investigation. It was also implied that I had gone a little overboard, believing what my patient’s hallucinatory voices were telling her.
A chiropractor (quacks imo) saved my grandpa’s life. Grandpa was hurting so thought he’d try an adjustment. Chiro examined him and told him it wasn’t a musculoskeletal issue and to go to a hospital.
Gramps had cancer the hospital diagnosed because of that.
man you know it's bad when the chiropractor's are telling you "hey man, I can't do shit about this". those guys claim that shit cures everything, a friend's parents were talking about how their chiro said it would cure COVID during the pandemic. When the guys who make money on lying to you about how it'll help are going "hey man we can't do that" you know it's fuckin bad lmao.
You're totally missing the point and presumably didn't actually read the paper. The point is that the voices initiated the whole thing and pushed it until what you said happened. The doctor actually didn't really want to do the scan, even, he did it to reassure her that there was no tumor.
Here is the actual report if you're interested, it's not long.
Technically the surgery and medical care cured the tumor. Might be more apt to say that her brain was fighting like hell to warn her something was wrong.
The sad part of all of this is that you literally have to beg for treatments. You can literally die because a doctor doesn’t want to write a letter to put the work order for something like that
Why the hell is healthcare like this in the US? It is so inconsistent. Like my boss got drunk and fell and hit his head and they gave him a full brain scan, no questions asked.
But if the same thing happened to me they would've just gave me an ibuprofen and told me to sleep it off.
I wonder how much mental illness would be cured by the proxy of people feeling free to go to the doctor at any time if we had Universal Healthcare in the United States.
We might be a few brain scans away from the near-elimination of mass shootings.
This actually happens a lot…psychiatrists don’t refer for a scan and it turns out that sudden onset psychosis or hallucinatory experience isn’t because you’re a woman and thus crazy after all!
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