Smug, sarcastic and bitter, Dr. Gregory House comes across as the doctor you would least like to encounter if some mysterious sickness landed you in hospital. Physicians may well dislike their patients, and perhaps their colleagues too, but usually they keep quiet about it. Not House. He speaks his mind, to the horror of patients and staff. He's one of the oddest ducks you'll encounter on television, and easily the nastiest character installed as hero of a TV show since Archie Bunker showed up in 1971.
House defies the warm-hearted treat-the-whole-person theories preached in medical school. "Isn't treating patients why we became doctors?" a young colleague asks him. "No, treating illnesses is why we became doctors," House replies. "Treating patients is what makes most doctors miserable."
He's the unlikely core of an irresistible series called House, which started last fall on Fox and Global. At a fictional hospital in Princeton, N.J., he runs a diagnostic unit with three residents, all of whom he tortures by commenting often on their inadequacy.
House won't wear a white coat because he thinks it looks dorky (or just to be ornery) and he's usually unshaven in a way hinting at imperfect hygiene. He brings to medicine the egotism of pop artists who believe they can get away with anything. He's a diva diagnostician.
He's tolerated because he's the world's (or anyway west-central New Jersey's) finest disease-detector. He infuriates his boss, but she admits, "The son of a bitch is the best doctor we have."
The wrong actor would make House repellent and sink the whole enterprise. But the producers, in a stroke of genius, chose a funny Englishman with expressive eyebrows, Hugh Laurie, who played Bertie in Jeeves and Wooster 15 years ago and still shows up on Blackadder reruns. As House, he talks pure American. (Off-screen he speaks with the accent his parents purchased at Eton.)
David Shore, the Canadian writer/producer, modelled House on Sherlock Holmes. Like Holmes, House solves problems by deduction, intuition and superhuman knowledge. Where Holmes plays the violin, House plays the piano. Where Holmes wastes time reading personal columns, House watches soap operas. James Wilson, an oncologist, serves as Dr. Watson, the question-asker and explainer.
House reproduces Sherlock's conversational tone in an American style.
Of Holmes, Watson wrote, "There was a world of sarcasm in his voice." That could apply to almost everything House says. He's also skeptical like Holmes. He believes all patients lie and he has to penetrate the veil of their mendacity.
And where Holmes had cocaine, House has Vicodin, buckets of it. That's a proprietary version of hydrocodone, a codeine-containing prescription painkiller that became popular in the 1980s and proved so addictive that it was soon for sale on the street and today provides a lot of business for drug clinics. (It was reportedly one of Rush Limbaugh's favourites.) Among other things, it induces euphoria. As a UCLA professor wrote a few years ago, "Who ever thought that plain old Vicodin would become the recreational drug of choice?"
An obstruction of blood in the muscles of his right thigh forces House to walk with a severe limp, use a cane and endure persistent pain. So he pops Vicodin tablets like peanuts, unnerving his fellow doctors. Recently he admitted he's an addict but doesn't plan treatment. Addiction works for him: "I pay my bills, I make my meals, I function." Wilson pointed out that the pills have so eroded his personality that he now has no relationships. "I don't want any relationships," House says. The pills "let me do my job, and they take away my pain."
In TV tradition, the scripts follow a pattern. Every week baffled doctors bring in a patient with a dramatic but apparently unknown illness. House agrees (often reluctantly) to take charge. He and his team then come up with a treatment that makes the patient worse. Soon House is violating the rules in order to test his ideas; sometimes the residents break into a patient's home to find evidence supporting an environmental hypothesis House has cooked up. Eventually, all other theories having been disproven, the one possibility remaining (just as in a Sherlock story) turns out to provide the solution.
Somehow, House's unit seems to get every interesting case in the Tri-State area, such as the mobster who collapses just before testifying in federal court and entering witness protection (House has to decide whether he's faking), the renowned jazz trumpet player who wrongly believes he's dying of Lou Gehrig's disease (House saves him, but only by violating medical ethics) and the presidential candidate who becomes violently ill during a fundraiser and tests HIV-positive. On tonight's rerun, they have to cure a 12-year-old boy with real symptoms (something like pneumonia plus an incongruous rash) and an unreal explanation (a Ouija board has told him he's cursed).
We viewers probably have little idea what the doctors are talking about when they bat "neurocystercercosis" and "paraneoplastic syndrome" and "arteriovenous malformation" back and forth during their highly competitive conferences. But we work out what's at stake, sort of. We learn a little, if only about the scientific method -- and how much we don't know about our bodies. Laurie articulated one subtext of the series in a question he asked during a recent interview: "Would you rather have an unkind person who is right, or a kind person who is wrong?"
Watching House the other night suggested to me the possibility that while reality TV gets dumber, TV drama gets smarter. Another example: Numbers, on which a genius-level math professor devises clever algorithms to solve crimes for the FBI. There, too, we sort of know what he's talking about, though we can't possibly decipher the formulae streaming across his blackboard.
Laurie has developed a theory that viewers enjoy his show because many of them want to be like House, at least a little. House isn't held down by the normal gravity of social life. He just doesn't care what people think. But of course the laws of television prohibit a grouch from remaining grouchy forever. Eventually, something will alter him (the love of a good woman, probably the beautiful young doctor already on staff), revealing his inner tenderness. He'll turn into Gentle Greg, Dr. Nice Guy. If that happens, convention will be satisfied, hearts will be warmed and the program will be destroyed.