Back to House.

Yes it is Tuesday night. No I have not been to the pub.

Yesterday (6/11/17) I complained that with the COP23 Summit and the war against the Islamic State of Iraq and the Levant (ISIL) life was being really hectic. So I did the only logical thing when times are troubled. I started binge watching the US TV show; "House."

This is the perfect thing for uncertain times. After all each episode across all eight seasons is the same predictable three act play.

Act One: A person is admitted to hospital with a mystery illness.

Act Two: The doctors think they have diagnosed the illness and start treatment. The treatment fails.

Act Three: The doctors diagnose another illness and start treatment. That treatment works and everybody ends up happy.

The show is that predictable that even if you come in half-way through you can tell you're in Act Two because someone will use the line; "Is it Lupus?"

This predictability became such a running joke apparently the writers started using it as a punishment. The actor who'd annoyed them that week would be given the line. Then at the end of each season they'd tot up how many times each actor had used the line. The one who'd used it the most then had to pay a fine.

Re-watching all this I can't help but regret that the show ended before they were able to cast Selena Gomez as a gueststar. After all this US popstar/actress has got to be the World's most famous Lupus sufferer. It might just be the magazines I read but it seems like every day I'm reading about Selena Gomez's battle with Lupus.

Reading those articles though uou can see why Lupus is such a staple of medical mystery dramas.

Lupus is an autoimmune disease. This means the immune system sometimes gets confused and starts attacking normal, healthy cells. Although I'm sure there is a good reason for this at present no-one seems to know what that reason is. Nor do they know why it stops and goes into remission as suddenly and mysteriously as it starts.

The most common treatment for Lupus is through low doses of a powerful chemotherapy drug. This suppresses the immune system to stop it attacking healthy cells. The irony is that this drug sometimes decides to team up with the Lupus and they both start attacking healthy cells.

Normally Lupus attacks the soft tissue in the joints such as the hands, knees, feet etc. This leads to inflammation that is extremely painful and can seriously effect someones quality of life.

However on rare occasions Lupus can start attacking healthy cells in the vital organs.

The big example from Selena Gomez was the kidneys. The Lupus causes inflammation in the kidney preventing it from doing its job. In Selena Gomez's case this became so severe that she had to have a kidney transplant.

In a way Selena Gomez was lucky. Most humans have two kidneys and really you only need a quarter of one in order to live. As a result transplants can be arranged from a live donor and if not you can live on kidney dialysis for years.

It's much more serious if the vital organ affected is something like the lungs. You can't really do a lung transplant from a live donor and you use your lungs so many times a minute you can't really wait a week to fit in an appointment at a dialysis clinic.

If Lupus starts attacking the soft tissue in the lungs then they can no longer supply the bloodcells with oxygen. This means that the bloodcells can longer supply all the other cells in the body with oxygen. Below a certain point those cells shutdown and die. This is known as respiratory failure and can lead to a much more serious medical condition known as; "Death."

Fortunately that failure point is actually extremely low. Normally Lupus goes into remission long before things reach that point. If it doesn't you can use steroids to suppress the immune system shutting down the Lupus. You can also gives the lungs extra help in the form of oxygen, pressurised oxygen and even, in extreme case, intubated ventilation.

The medical drama doesn't end there though. If you start suppressing your immune system - particularly if you've got damaged lung tissue - you become very susceptible to all the bacteria, virus' and fungi that hurtle around during Flu Season.

Synonymous with Acquired Immune Deficiency Syndrome (AIDS) probably the most famous of these is Pneumocystis Pneumonia (PCP). Although as a general rule if you're going to get one of these opportunistic infections you're going to get all of them.

Last Tuesday (31/10/17) there was an Islamist terror attack in New York City, New York, US.

This led to some discussion about whether the alleged attacker should be transported to Guantanamo Bay and subjected to interrogation techniques such as waterboarding. This involves pouring water over a person's face to simulate drowning.

ISIL make frequent use of Chlorine gas as a Chemical Weapon. This mildly inflames the soft tissue in the lungs.

Both waterboarding a chlorine gas are designed to make people think they cannot breath. The intention being to make the person panic. When you panic the body thinks you need more oxygen. Something which you can't do making the panic much worse.

So if you ever find yourself in a situation like that it's important to remember that you're not going to die. Well not of that. Not in the foreseeable future.

Also Southern Rail are dicks. That's nothing to do with anything. I just think we all need to be periodically reminded that Southern Rail are dicks.

Tomorrow (8/11/17) members of the Rail, Maritime and Transport (RMT) workers across Britain are going on strike in a dispute about driverless trains.

Customers of Southern Rail are not expected to notice.

23:45 on 8/11/17 (UK date).