House Season1 EP6

The Socratic Method

Episode 106 : 2004-12-21

A mother, Lucille Palmeiro, is hearing voices in her head. She feels a sharp pain in her leg, which turns out to be a blood clot. At the same time, Lucille's son, Luke, is working with a disability counselor to keep his mother's benefit checks coming in. She was diagnosed with schizophrenia last year. The clot moves to the Lucille's lungs and she collapses.

After Lucille is stabilized, a doctor explains her condition to Luke. The doctor is concerned that Luke is giving his mother alcohol, which he claims calms her down. House, overhearing the doctor's lecture, takes an interest in the case.

Why did this 38-year old woman develop a deep vein thrombosis? Dr. Wilson thinks House's only attraction to the case is the schizophrenia. House claims otherwise and drops in on the patient, which shocks Foreman and Chase. During his visit, House learns that Lucille has tremors which prevent her from shaving her legs. She must be bleeding more when she cuts herself. House orders a round of blood work.

Foreman tries to draw blood, but Lucille resists, exclaiming that they're going to steal it. She has to be forcibly restrained. Luke is upset with House for giving his mother Haldol to knock her out. She claims that Haldol makes her soul numb. That night, Lucille begins vomiting huge amounts of blood.

House upbraids Foreman for the dose of Haldol. House wonders if a Vitamin K deficiency explains the delay between the blood test and the vomiting. Foreman and Chase check the patient's home for any unused Anbecillin, which was prescribed earlier this year for a sore throat. Foreman finds a strongbox filled with meds, including an untouched bottle of Anbecillin. They also find a freezer loaded with microwave burgers. Luke says that's all she eats. House's theory about Vitamin K is becoming stronger.

Chase refuses to believe that the cause is merely a Vitamin K deficiency. He's sticking with alcohol as the cause. Chase and Cameron ultrasound Lucille's liver and find cirrhosis and a cancerous tumor. She needs a transplant because the tumor's size is past surgical guidelines. House suggests injecting ethanol into the tumor to temporarily shrink it so that the surgeon is fooled.

The surgeon operates, but is angry about House falsely shrinking the tumor. Social Services shows up to take Luke away. House starts to wonder if Lucille is actually crazy. That night, House accuses her of calling Social Services so that somebody will take care of her son. House agrees with the call, but that is a sane decision made from self sacrifice, and that doesn't fit in with schizophrenia.

Late that night, House has a revelation and begins calling Lucille's old doctors. They all hang up on him because it's so late. House thinks a specialist made an easy diagnosis. He gathers his team to search for other explanations to her symptoms. Wilson's disease is marked by high copper levels in the body. That does explain the cirrhosis. Seeing that Lucille cancelled an eye exam last year, they give her a quick test. The copper-colored rings around her corneas are a dead giveaway. The doctors start treating her for Wilson's disease.

Within a few days, a perfectly cogent Lucille is happily reunited with Luke. And House takes the blame for the call to Social Services.

第6集（EP06:The Socratic Method）
1.標題：The Socratic Method
Socratic Method，即蘇格拉底方法，本集中House和Wilson的對話中就提到過這個方法，也是本集做最後診斷時用到的方法。
蘇格拉底和人討論問題時，常用的一種方法。這種方法以懷疑為方法，作為探求真知的手段。由懷疑引出問題，然後引發討論甚至辯論，以尋求真理和概念的正確定義。整個方法是啟發和探求式的。這種談話有幾個特點：

第一、談話是借助於問答，以弄清對方的思路，使其自己發現真理。而在談話過程中，蘇格拉底本人偏向於問，不輕易回答對方的問題，而只要求對方回答他的問題。而他從對方的回答中引導出其他的問題，知道由於不斷的盤問，使青年承認他的無知。
第二、青年們想要學習，必須交談，由交談而建立友誼，這樣才有助於問答的進行。因此增進友誼和探尋知識，構成蘇格拉底方法的兩個基本要素。

很多人都喜歡House每集裡和手下的醫生討論病情的場景。現在可以很容易的知道，House用的一直是蘇格拉底方法引導教育手下的。

2.開始6分23秒左右的House和Wilson關於精神分裂的對話
這段對話在TV.COM的論壇裡有人認為是House和Wilson最好的對話之一，兩人的反應都相當快。用到了許多比方：

HOUSE: On the other hand, we don't really know anything about schizophrenia, so maybe it is connected.
HOUSE: 換個角度，我們對精神分裂一無所知，所以這個病例只是可能（和精神分裂）有關。
WILSON: Well, the schizophrenia explains one mystery  – why you're so fascinated by a woman with a bump in her leg. Like Picasso deciding to whitewash a fence.
WILSON: 精神分裂說明了一個問題－為什麼你對一個腿部有腫塊的女病人如此著迷（指HOUSE過於注重病人腿部的血栓了）？就像畢加索要刷白他的籬笆(1)。
HOUSE: Thanks. I'm more of a Leroy Neiman man. And it is only about the DVT. She's 38 years old, she should be…
HOUSE: 謝謝。我更喜歡雷若伊尼曼(2)。因為那是D.V.T（Deep-Vein Thrombosis，深靜脈血栓），她才38歲，她應該...
WILSON: Right. Solve this one and you're on your way to Stockholm.
WILSON: 是呀，治好了這個，你就可以在去斯德哥爾摩(3)的路上了。
HOUSE: We don't even know how to treat it! Come on! Fumigation of the vagina?
HOUSE: 我們甚至還不知道怎麼治它！難道用煙熏陰道(4)麼？（幾個護士回過頭來看他）
WILSON: A little louder -- I don't think everyone heard you.
WILSON: 再大點聲－還有人聽不見呢。
HOUSE: Two thousand years ago, that's how Galen treated schizophrenics – the Marcus Welby of ancient Greece.
HOUSE: 兩千年前，古希臘的Galen(5)就是這麼治療精神分裂者Marcus Welby(6)的。
......
WILSON: Where are you going?
WILSON: 你去哪？
HOUSE: Going to see the patient. That all-important human connection. Thought I'd give it a whirl.
HOUSE: 去見病人。人與人之間的聯繫很重要的。我想試試。
WILSON: You won't talk to patients because they lie, but give you patient with no concept of reality…
WILSON: 你以前從不和病人談話，因為他們會撒謊。但你現在卻去和一個對現實毫無意識的人去談話...
HOUSE: If it wasn't for Socrates, that raving untreated schizophrenic, we wouldn't have the Socratic method – the best way of teaching everything, apart from juggling chainsaws.  Without Isaac Newton, we'd be floating on the ceiling.
HOUSE: 如果不是因為有了蘇格拉底，那個語無倫次的未治癒的精神分裂患者，我們就不會有蘇格拉底方法－教導一切的最好的方法，除了教你怎麼用電鋸殺人(7)。如果不是牛頓，我們現在還在天花板上(8)。
WILSON: Dodging chainsaws, no doubt.
WILSON: 是呀，在天花板上躲電鋸。
HOUSE: And that guitar player in that English band – he was great. You think I'm interested because of the schizophrenia.
HOUSE: 還有那個英國樂隊裡的吉他手(9)，他太偉大了。你認為我是對精神分裂感興趣？
WILSON: Yeah. I'm pretty sure.
WILSON: 我肯定。
HOUSE: Galen was pretty sure about the fumigation thing. Pink Floyd.
HOUSE: Galen對那個煙熏消毒的事也很肯定呢。Pink Floyd.(10)

由於這段話裡牽涉到很多隱喻，所以在之中編了號，下面集中解釋下：

(1)畢加索是誰就不用說了。這裡Wilson說House把精力放在一個血栓上，就像畢加索去刷籬笆一樣，大材小用。
(2)雷若伊尼曼（LeRoy Neiman）是美國當代最受歡迎的畫家之一，擅長抽像的人物畫。眾多世界級品牌商品無不為引用尼曼的設計而感到自豪，遍覽現在的廣告宣傳，往往能看見廣告中專門提到尼曼的大名。但是一些批評家認為他只是一個代表流行文化的畫家而不能算一個真正的大師。
(3)斯德哥爾摩。這裡暗示諾貝爾生物和醫學獎。每年的諾貝爾獎都是在瑞典首都斯德哥爾摩頒發的。毫無疑問Wilson這是在調侃House，因為如果只是治好個深靜脈血栓的話，是不可能拿諾貝爾獎的。
(4)這個地方字幕應該錯了。Fumigation在醫學上應該是指用蒸汽或煙熏某個地方來達到消毒的目的，而不是什麼「怨恨」之類。
(5)Galen（Claudius Galenus）是公元2世紀古希臘的醫生。他在帕加馬城（Pergamum）的研究影響了西醫1000多年。他認為人的思想是由靈魂所控制的，也就是元氣，元神，和空氣有關。所以精神方面的疾病是由於不乾淨的空氣所導致的，尤其是女人，更容易患這類疾病（因為下身更容易接觸到氣體-_-!）。所以才有了上面(4)House所說的「難道用煙去給陰道消毒」一說。
(6)Marcus Welby。這裡的Marcus Welby可不真是什麼歷史上被Galen治療的精神分裂者。而是上世紀70年代，歷史上最賣座的醫務劇之一，Marcus Welby, M.D.（《Welby醫生》）中的主角Marcus Welby醫生。Welby醫生以體貼關心病人著稱，和House將病人視作難題和麻煩的觀點截然不同（House無疑是個十足的反Welby主義者）。因此House這裡才調侃他是精神分裂患者，並且還要接受Galen的治療。[s:233]
(7)美國人提到殺人，總想到電鋸。美國歷史上曾經出過的著名的連環兇殺案，犯人將人殺害後用電鋸肢解。後被稱為德州電鋸殺人狂。和倫敦的開膛手傑克一樣，這些都是西方歷史上著名的殺人狂。
(8)牛頓提出的萬有引力定律，中學就學過了的，沒有萬有引力的話，我們確實可以飛到天花板上去（多酷呀）。該定律和牛頓運動定律構成了現代物理學的基礎。
(9)這個吉他手指的是Pink Floyd樂隊的創始人巴雷特（Syd Barrett）。在甲殼蟲樂隊（Beatles）之前，Pink Floyd樂隊是上世紀6，70年代最紅的英國搖滾樂隊。然而在樂隊就要到達事業巔峰時，巴雷特卻因精神分裂不得不退出樂隊。House的扮演者Hugh Laurie是英國人，所以House裡列舉了很多英國的名人事跡。
(10)這裡House總算想起了前頭所說的那個英國樂隊的名字。所以才知道前面他說的英國樂隊是哪一支，因為搖滾樂隊裡像精神分裂的人實在太多了。 ^^!

3.The New York Mets

HOUSE: And the meds…
HOUSE: 關於藥...
LUCY: Baseball! I like baseball.
LUCY: 棒球！我喜歡棒球。
HOUSE: Very nice.
HOUSE: 很好。
LUCY: Very sad.  My boy and me – we went to see a game.
LUCY: 很糟。我和我兒子去看了一場（Mets隊的）比賽。
HOUSE: Not 「Mets」 – meds – medicine.  You take what he tells you to take.
HOUSE: 不是「Mets」，是meds－藥。你吃了他要你吃的藥。

House這裡問本集的病人Lucy關於藥的問題時，Lucy回答說自己喜歡棒球。這倒不是說因為Lucy精神分裂，神經有問題才答非所問，而是Lucy將House所說的藥（meds）聽成了紐約Mets籃球隊，一隻紐約皇后區的籃球隊。後來House從病房裡走出來的時候，對Wilson咕噥了一句「the Mets suck」（Mets對是垃圾）。在32分54秒時候，Lucy的兒子被社會福利機構帶走的時候，Lucy對他說：The Mets lost. You remember?（Mets隊輸球的時候，你還記得麼？）。由於不知道Mets是什麼，所以這些牽涉到的地方的字幕都有錯誤。

4.Her Praise（《她的讚美》）
在本集開始Lucy吐血的那段，她的兒子Lucas讀了一首詩（應該是Lucy最喜歡的詩吧）。在片尾Lucy接受治療的時候（39分49秒），她也讀了這首詩。
這首詩是1923年諾貝爾文學獎得主，愛爾蘭大詩人，劇作家，參議員葉芝（也作「葉慈」，William Butler Yeats）在1919年的詩集《庫勒的野天鵝》（The Wild Swans at Coole）中的作品《她的讚美》（Her Praise），原詩後四句如下：

If there be rags enough he will know her name
And be well pleased in remembering it, for in the old days,
Though she had young men's praise and old men's blame,
Among the poor both old and young gave her praise.

風軟字幕用的是傅浩的翻譯的《葉芝詩集》，是流傳最廣的譯本，在這裡可以下載到。

5.FOREMAN: Mickey Mantle had a whole bar named after him. He got a transplant.
HOUSE: Yeah, well, Lucy can't switch-hit.

FOREMAN： Mickey Mantle死後有個酒吧都以他名字命名了，他都獲得了移植。
HOUSE： 沒錯，可是Lucy不會全壘打。

24分47秒處，當Lucy的肝腫瘤被發現後，House說因為Lucy酗酒（窮，只能靠喝酒取暖），所以難以獲得肝臟移植。Foreman就舉了Mickey Mantle的例子來反駁他。Mickey Mantle是上世紀5，60年代紐約洋基隊（New York Yankees）的著名棒球選手。除了全壘打外，他場外不檢點的作風和酗酒也同樣著名。因此他知道1995年，63歲時才接受到肝臟移植手術，幾個月後就去世了。此處字幕應該錯了。

6.Chase: The Madness of King George.
38分07秒的時候，也就是House本集最後和手下們用蘇格拉底方法討論病因的時候。Cameron診斷為噗林症，Chase說：喬治王的瘋狂。
The Madness of King George是1994年一部電影的名字，由艾倫班尼特（Alan Bennett）飾演主角喬治王三世。喬治王是當時英國的國王，以反對美國獨立運動而聞名。在美國獨立後，喬治王得了精神錯亂。科學家現在認為喬治王當時得的就是噗林症。這裡Chase還在調侃House，因為在94年的那部電影中，House的扮演者Hugh Laurie出演的是喬治王子，喬治王的兒子。-__-!