Reflection on House of Cards I

If you were like me snowed a bit this past President's weekend, you might have found yourself drawn to the second season of "House of Cards."  The major event that comes in the middle of the first episode is Frank (Kevin Spacey) throwing Zoe (Kate Mara) under the train. He then leaves and seemingly without a trail. At least a trail detective in the second episode cannot find. Lucas (Sebastian Arcelus) examines the surveillance video with one of detectives at the District police department. The detective says there were two witnesses, and both are duds. So Frank washes hands in the first episode, and becomes a president in the last.

Seemingly unstoppable Frank, who was denied the post of Secretary of State in the first episode of the first season frees himself from all allegiances, and with his wife Clair (Robin Wright) presses ahead through power plays and schemes screwing people lives until he becomes a president via vice presidency (thus you may guess requiring a resignation of the elected president in the process). No one seems a worthy opponent who can crack Frank's intentions and bring him down. Several have tried in vain. Journalists investigating the suspicious suicide of the Congressman Russo (Corey Stoll), businessman Raymond Tusk (Gerald McRaney) who in the end sells out President Walker,  the president Walker (Michael Gill) himself briefly gets a whiff of Frank's malfeasance as his (Walker's) political demise nears, but then lets his guard dissipate again in the face of obvious clues of Franks' treason. 

There were lots of chances to make Frank's life more difficult and, in my humble opinion, show more thrilling. But the writers seemed to be so preoccupied with fitting the process from Frank's becoming the VP to his presidency in 13 episodes that many story-lines felt sloppy, underdeveloped, and frankly did not hold water for how clearly unrealistic they were.

In this regard, the story-line that bothers me is the one with Zoe's death. Zoe comes to meet Frank disguised in a fedora and thick-rimed glasses at the train station and ends up under the train; he pushes here onto the tracks after a dialog. He then leaves seemingly incognito, while walking in the direction opposite everyone is running to see what happened, and uncaptured on surveillance tapes. No evidence to suspect or prove a foul play. I am sure everyone watching thought, "Oh c'mon, seriously!" Perhaps the writers wanted to avoid the whole "what if he is captured on the surveillance" story, but we don't need a CSI-style investigation to claim an unrealism of this line of thinking. With cameras watching every corner, Frank (or at least a figure leaving the station) would have been seen and exposed. In fact, the right of the surveillance video Lucas is watching with the detective  (the lower picture) shows where Frank exited after having pushed Zoe. There is certainly the evidence of foul play. So go from there, detective.

This is not to say the Frank should have been exposed and accused of murdering Zoe, but I would have liked to see this plot developed rather than pushing Lucas into deep web and locking him up for cyber terrorism (what a doozy subplot).

Bloody mess

My biggest fear is for the code pager to go off while I am in the restroom.

It did go off angrily followed by the overhead PA system announcement the code location. The unit to which I was instructed was located a hike away from where I was standing watch, but it's all hands on deck at nights. By the time I get there, running overpasses across the hospital and climbing stairs avoiding slow elevators, the code team localized to that section of the hospital is firmly in control. Anesthesia team is intubating, intensive care unit crew is assessing and making the transfer arrangements. Seeing the order coming out of chaos, I sign off and head back to my tower. One of the intesivists wishes me a good night, "See you at the next code," he says.


Back to my hematology unit, where I am watching over thirty-four patients trusted to me by the day teams, my spectralink house phone goes off incessantly.

"Ms. B. has a fever of 100.8. She _is_ neutropenic; do you want to culture her and start antibiotics?" "Sure, I'll put the orders."

"Ms. M's platelets are 4."
"Yes, I know. I need to speak with the blood bank since she needs special platelets. Is she bleeding anywhere?"

"Ms. L.'s heart rate is 150, and blood pressure in the low hundreds."
"Please do an ECG, and I will be right there."

"Mr. F. has a temp of 103, his rigoring and breathing at 30. He is going to hospice tomorrow morning. What would you want to do, doctor?"
"I will be right there"

"Ms. C. has soft blood pressures, heart rate in 120, and she has not had made urine since the beginning of the shift"
"Give her a liter of normal saline bolus. I will be right there."

"Hi, is this heme service?"
"Yes."
"You have an admission from the emergency room. He just arrived on the floor."
"Oh. What is he here for?"
"I will be right there..."

I look at my spectralink that says "Bloody Mess" where it should be "Hello, World." The code on my floor is just a matter of time. No time for a restroom break.

Code pager goes off again. _Not_ my floor. Where? East Pavilion. Stairs down, bridges, stairs up. Running through the mental checklist of what to do when I get there. Same intensivist joins me on the run, "Get me there the shortest way." "No problem boss, hang on to your badge."

The day team starts to trickle in. Interns first. Early. Hair is still wet. Time to sign out the service back to day teams.

"OK, so Ms. M. got her matched platelets. She is fine."
"Ms. B. had a small temp, cultures sent, broad-spectrum antibiotics. She is fine."
"Ms. L. was in atrial fibrillation, there were no telemetry beds, so I managed her on the floor. She converted back to sinus. Blood pressures stable. But watch her closely today. She will need a cardiology consult."
"Mr. F... had a fever and rigors, but better with morphine"
"Mr. C...needed some fluids."
"Oh, and you have three new admissions."
"But nobody coded."