House MD is a perfect show. I feel confident saying so, since now I’m at the end of my first rewatch of the show. Of course, House is a bad show, with a formula that dries up by the start of the fifth season and a cast that only had 4 members stick it out through the 8 seasons, but it’s also the perfect show. It’s half Sherlock adaptation, half medical thriller, with a dash of early 2000s insensitivity towards every protected class in the United States. It should be a terrible show, but somehow the pieces align to make an incredible show. Though maybe that’s the Stockholm Syndrome of an 8 season show talking.\
The show stars Hugh Laurie as Dr. Gregory House, genius diagnostician (a fake kind of specialist who diagnoses people and nothing else) working in New Jersey. House is disabled, with a limp from a surgery he got prior to the events of the show which is also the source of his chronic pain. He is abrasive, rude, and waits until after the 3rd ad break in every episode to come face to face with the patient for the first time, if he sees them at all. But damnit if he’s not the best damn doctor in this hospital goddamnit, and so on and so forth. House works with a team, 2-4 young doctors that rotate throughout the run of the show, who are there for House to bounce ideas off of and ridicule whenever they say something that’s obviously silly, at least according to House.
The structure stays consistent like so many other early 2000s sitcoms, but House is far-and-away the most tightly formulaic show I’ve ever seen. 80-90% of the episodes follow the same roadmap: the episode opens on a character we’ve never met who suffers a medical emergency. We have a scene of House arriving at the hospital or the team sitting around talking about the B plot. The dean of medicine gives House the case of the person from the opening, usually with a handful of details that prevent House from immediately solving the case. The Team comes up with ideas, House shoots a few down, until he hears one he can’t immediately dismiss and sends The Team to confirm and treat the first guess. The Team treats the patient while philosophizing over whatever unique trait the patient has (ethical nonmonogamy, genius IQ but not using it, treating a sex doll like his girlfriend, need I go on?). We get another B plot scene before we get back to the patient. The first guess is wrong, and now the patient’s coughing up blood or their kidneys are failing or they have a mysterious rash. The Team doesn’t know what it is, but they know it’s not the first guess. First Ad break. House sends The Team to break into the patient’s home/workplace/military bootcamp (yes really) to search for toxins. They find something, they try to treat, a few scenes go by and now the patient’s liver is failing or they just suffered a psychotic break or they just got put on bypass. Whatever happens, they’re running out of time. Second Ad break. The Team is out of ideas, and they’re scrambling for an answer. They come up with a longshot, risky treatment, and House resigns himself to at best, sulking, and at worst, considering the case solved. There is a climactic scene in the B plot and in the middle of a conversation, we get a medium close-up on House as he looks off into the middle distance and has a realization. He walks out of the room, with later seasons giving his scene partner a snide comment about how often he does this. House barges into the patient’s room or interrupts their surgery telling the Team to stop treatment, and that the answer was right under their noses all along. It was a parasite, or cancer, or a liver disease that got a false negative during earlier tests. It’s always systemic, it’s always treatable, and it’s never lupus. Third ad break, denouement, end of episode.
This formula is genuinely compelling, at least for the first few seasons. But by season five? Eight? There are only so many twists, so many unique kinds of patients, so many rare systemic diseases the writers can come up with before what originally made the structure compelling turns stale. It’s the age-old issue with problem-of-the-week serialized stories: growing out of the foundation you laid at the beginning. I think of Buffy the Vampire Slayer, because when am I not thinking about that show? Sure we can start the show with unique monsters to fight each week as the hook, but eventually people are going to care about the characters doing the fighting much more than how cool the monsters are. The formula becomes homework surrounding the character drama the showrunners would much rather be writing. House has the same problem. By season three, I’m not tuning in every week to watch House solve a medical mystery. I’m tuning in every week because I like House, or Wilson, or Foreman, and I want to see more of them. Maybe when you start going to a coffee shop you go for the coffee, and keep coming back because the coffee’s good, but after years of the same coffee you keep going because it feels like home and you like how the baristas treat you.
My issue with House isn’t the formula, however. It’s the 10% of episodes that break the formula. Unique episodes are constructed in a simple way, by taking the formula and altering a part of it to make it more dramatically potent. This week it’s a classic House case but the patient is a main cast member. It’s a classic House case but instead of working at the hospital House is working in a collapsed building. It’s a classic House case but House is obsessed over a case he failed to solve that’s similar to this week’s case. The 10%, the ones that break away from the formula, irritate me. They irritate me so much because they are genuinely great television. My issue with House is that it’s a fantastic show parading around as a just pretty good show.
The best House gets is when it focuses on the psyche of its main character. Every character is more compelling when you see them out of their element, but that satisfaction and mystery is only compounded when the character’s element is them being a crusty asshole who’s only kept around because he’s a genius. We get to see a lot of Greg House over the course of the eight seasons. We see him surrounded by different team members, saving patients, losing patients, ignoring his Vicodin addiction, struggling with his Vicodin addiction, going to rehab, relapsing, getting into and blowing up every relationship we see him in, going to jail, and somehow never losing his medical license. We see him bond with a few patients, even though he avoids bonding at all costs. We see him be a good friend and a bad friend, and all of these character moments are centered around his pain.
House doesn’t shy away from its main character’s disability and chronic pain. If you know Gregory House for three things they’re probably his cane, popping Vicodin, and medical malpractice. However, on an episode-to-episode basis, House’s injury and pain don’t get much attention other than the rationale for his gruff exterior. In good episodes, House’s pain management is the focus of a B plot. In great episodes, his pain is tied back into the main plot. The patient this week is also an addict, or is facing amputation, or House’s attempts to defeat his pain this week have made him a worse doctor. House is always in pain, and the show is at its best when it doesn’t leave that fact undiscussed outside of Hugh Laurie’s portrayal of the character.
From the discussion of House online within disabled communities and fans of the show who also deal with chronic pain, House seems like an example of good and realistic representation. Gregory House is always in pain; the severity ebbs and flows but the pain is always there. Monologues that stronger scripts give Laurie articulate his relationship with the pain, that he hates it, would do anything to dull it, and has considered suicide as a way to avoid the pain. Most importantly, for a show with a disabled genius doctor, House’s disability is never cited as what makes him brilliant, or that he was kind before the accident. House has always been like this. Now he just has more to deal with. Yes it ruined his marriage and got him addicted to Vicodin, but this is the same House as ever, just with more baggage. House is a whole character, with his chronic pain and disability being a single, albeit important, dimension of his reality.
That is why I say House is a perfect show, or at least has perfect moments. The formula is strong, yes, but flat. There are good scripts, however, every few episodes. These scripts hold up the show to the light, turn it in its hands, and look at the colors that shine off the new shape, those are the scripts that make me stick around. When House lets its titular character be a character and not a snarky plot device the show revolves around, it tricks you into thinking it’s a great show. When House shows himself as the man he is and not the god the narrative wants you to see him as, I don’t hesitate to call House a perfect show.
It’s at this point when I tell you I’m not just writing about House because I like the show. It’s at this point when I tell you I was inspired to write while bedridden with an infection that made sure I couldn’t walk properly for a few days, and had been itching to write about House for a while. I had a bad limp for the better part of a week and luckily have been pain free for a few days, but those days of pain were enough of a drain on me that I knew I had to write. To ease the burden or make sure I didn’t go insane.
Two times in the past few months have I had infection-based persistent pain. A few months ago, when I contracted mono, and the week that I’m writing this. Both were brought on by things I could control but had never really thought to, and neither responded to my painkillers.
I find pain to make me feel, above all else, pathetic. Pain makes me feel like a child who thought they could venture out into the great wide world on their own, wound up hurting themselves, and now needs to be helped, to be coddled. Especially when the pain comes from my own negligence, or at least feels that way, I tend to feel like I am woefully unprepared for the world. It’s not like I could’ve avoided either of my infections without being the kind of health nut that doesn’t live a worthwhile life, but pain every time you swallow or take a step doesn’t listen to that kind of logic in the moment. All that the voice of pain tells you from the back of your mind is “This is the strongest, smartest, and best you’ve ever been and you still got sick. You’re still in pain.”
Of course, pain also makes me feel like a child because of its selfishness. When pain cannot be managed internally, care is sought, even if it’s just a friend to be around to take the edge off with conversation. Unfortunately, pain also turns you into a worse version of yourself, someone who is spinning one extra plate on that day and can’t put the same effort towards social convention or compassion. So, pain demands proximity to care while making you harder to be around; pain demands unconditional care. Pain demands a parent. I am not a person who views every interaction as transactional, nor do I hold on tight to the kind of person who would let me go after one bad day, but I am the kind of person who has trouble asking for help and someone who sees care in times of need to be incredible kindnesses that the people I love have offered. I believe we are all better off when everyone tries to give as much as they can, so you can imagine my issue with pain turning me into nothing but a receiver.
I would keep preaching about pain, but this is one of those things that, unfortunately, I can guarantee you’ve felt. You know the isolation, you know the hate you feel towards the person pain turns you into. Maybe you’re more gracious towards that version of yourself than I am, but anyone who doesn’t always operate at that level of sheer vulnerability has a level of distaste for it. You know which painkillers work and which don’t, and you know when you need to use each to be the version of yourself you like. Maybe you don’t know which version of yourself you like yet, but know at the very least it’s the one that’s not in pain.
Inescapable pain has the habit of breaking every layer of armor you’ve accrued throughout your life. No matter how much you’ve changed, no matter how many barriers you’ve put up between yourself and the world, pain strips all of that away and leaves you bare. Or maybe that’s where the pathetic feeling comes from; it stems from the feeling that you could’ve done more. You could have prevented this pain if you were a little stronger, were a little more careful, could handle spinning more plates, but you can’t. You failed, and now you pay the price by being a worse version of yourself while demanding you be around the people you love. You don’t deserve them and they deserve better.
But of course, none of these thoughts are rational. As soon as the pain fades and you’re allowed to be your normal self again, you know that we’re still on this Earth because of the things we didn’t need to do but did anyway for the people we love; that we can only survive off of good will and not responsibility.
This is why I adore House. As much as it wants to treat Gregory House as a god, it knows he’s a human. The show, when it chooses to, lets him feel his pain, letting the audience see into the vast depth of feeling that is always just below the surface. The narrative does this through pain, the one thing that every human has experienced, and that means that every human can intensely empathize with House. Even if we hate House, we most likely have a gut reaction that no human should be in that much pain. I love House when it drops the act and shows us that the best doctor in the world lives a life similar to ours, and in my opinion, the show drops the act better than any other show out there. That is why House MD is a perfect show.