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- "You’re orange, you moron! It’s one thing for you not to notice, but if your wife hasn’t picked up on the fact that her husband has changed color, she’s just not paying attention. By the way, do you consume just a ridiculous amount of carrots and mega-dose vitamins?"
- ―House's diagnostic method
Visitors to the House Wiki were polled on who was the "most clueless clinic patient ever" and Orange Man was their most popular choice.
Orange Man was House's first clinic patient after returning to the clinic after a refusal to do clinic duty for six years. Orange Man came into the clinic claiming that his back had become sore while he was golfing. House gave him a Vicodin for the pain. House told him that he was orange and apparently he had not noticed. House also told him that his wife is having an affair because it was one thing that he hadn't noticed that he was orange, but if his wife hadn't noticed than she must not have been paying any attention to him. He asks the patient if he eats "insane amounts" of carrots and multi-vitamins and the patient nods.
House diagnoses the orange skin as being caused by eating too many carrots turning him yellow (due to excess of carotene, a natural dietary pigment), along with Niacin (Vitamin B3) turning him red.
He came back to the hospital once more to complain to Lisa Cuddy about House's behavior. It appears that he and his wife had had a falling out because he no longer had the ring on his finger that (or he's taken the ring off to see if his wife is really ignoring him as much as House says). Cuddy was sympathetic but refused to discipline House as he was "the best doctor we've got".
Reaching the diagnosis Edit
Pretty easy on this one. The most common cause of orange skin is overconsumption of foods high in beta-carotene (carotinemia). House would have had to rule out the most common alternative diagnoses. Jaundice is unlikely in an otherwise healthy person, as is hemochromatosis. House quickly confirms by asking the patient if he overconsumes foods rich in beta-carotene.
Red skin is a bit less specific and can be caused by dozens of different conditions. However, anaphylaxis can quickly be ruled out as the patient is in no discomfort. Cirrhosis is next, and often goes together with yellow or orange skin, but again the patient's overall health points away from it. Next are skin diseases, but other than the color, the patient's skin appears to be healthy. Carcinoid syndrome is more rare, but again the patient's overall health points against it. Although it's a bit of a stretch, tied together with the carotinemia, an excess of a vitamin is a good guess.
Explaining the medicine Edit
- When a person eats foods containing carotenes, the carotenes are processed by the liver into Vitamin A. From there, they work their way through blood plasma to the peripheral tissues, including the skin. In a person with a normal diet, these carotene derivatives, which are orange coloured, are a normal part of skin pigment. When a person overconsumes carotenes, more of these pigments are created and more work their way to the skin. Although the body eliminates some carotenes through the urine and intestines, many are eliminated in the body's natural production of oils (sebum) and through sweat. As such, they tend to accumulate in the skin.
- The amount of carotene required to be noticeable as carotenemia is the equivalent of about five medium sized carrots a day for a period of at least four weeks.
- Niacin can cause skin flushing as a side effect. It usually lasts for 30 minute, but can last for up to two hours.
Purpose of the character Edit
For the sake of efficiency, minor characters should either advance the plot or develop the main characters. It's pretty certain that in television writing, where timing is everything and scripts must be precisely the right length, that the presence of Orange Man is treated as an opportunity to both fill time and to develop either the plot or the characters.
In this case, Orange Man is primarily in place to develop House's character. His surprise appearance at the end continues this process. In his short time on screen, we see:
- That House can't be trusted to be polite to patients. To this point, House has never interacted with a patient in the series. He doesn't interact with Rebecca Adler until later in the episode. Allison Cameron has already warned Eric Foreman that House doesn't like to meet patients. As the audience, we wonder "how bad could it be". In his first interaction with a patient, we find out. This interaction sets the tone for all of House's other interactions with patients in the series.
- That House is a deductive genius. With the patient for barely a minute, House not only comes up with a relevant medical diagnosis, but nails a non-medical conclusion as well. It all seems to flash into his mind. He doesn't have to wonder about things or talk things through. Things just come to him.
- That House has serious problems with Vicodin. This is the first time that House has openly taken Vicodin in front of a patient, and it won't be the last.
- That Cuddy puts up with House for a reason. House's behavior with this one patient is probably enough to fire him, or at least seriously discipline him. Cuddy will probably pay a price for refusing to do anything about House's behavior. Throughout the episode, she threatens House and does, at one point, cut off his privileges to make a point. However, in the end, she must put up with House because she simply doesn't have anyone to replace him.
In addition, like most patients, Orange Man provides comic relief. In a dramatic series, it is important to allow the drama to be put aside once in a while to give the audience a break.
What is a rich donor doing in the free clinic? We don't know it's a free clinic at this point, and we do see well off people in the clinic in future episodes trying to save a buck or two (see Nose Patient). However, we also see that people have to wait for hours to see a doctor and get only minimal medical attention.Orange Man is a donor. He has money. He probably has insurance too. Why on earth is he there in the first place?
- Orange Man is one of several characters who has no known first or last name
- Orange Man is one of several characters whose relationship breaks down after meeting House
- The school colors of Princeton University are orange and black. During homecoming, students usually wear either orange and black outfits or wear orange and black makeup. If the episode took place during homecoming, Orange Man probably wouldn't even have stood out.
Cultural references Edit
- Orange Man's relationship breakdown is probably drawn directly from the Sherlock Holmes story "The Blue Carbuncle" and the character Henry Baker. Holmes only has the man's hat to work with and figures out his wife no longer loves him:
- Holmes: "This hat has not been brushed for weeks. When I see you, my dear Watson, with a week's accumulation of dust upon your hat, and when your wife allows you to go out in such a state, I shall fear that you also have been unfortunate enough to lose your wife's affection."
- Watson: "But he might be a bachelor."
- Holmes: "Nay, he was bringing home the goose as a peace-offering to his wife. Remember the card upon the bird's leg."
- — The Blue Carbuncle
- The House, M.D. parody episode of Scrubs "My House" directly refers to Orange Man