The Hollywood Medical Reporter – House M.Dby Daliah Leslie | August 14, 2014
Unless you’ve been distracted by an opiate-induced cloud, you’ll be familiar with Dr. Gregory House and his Sherlock Holmes-like ability to riddle his way through a web of peculiar symptoms to find the right, and usually unbelievable, diagnosis.
By season three (out of eight, spanning from 2004-2012), House M.D had reached its peak Nielson rating with an average of 19.4 million viewers and ranked 5th out of the entire U.S. television market. Even as the show’s ratings began to slip by season five, it remained Fox’s most popular show after American Idol.
I liked the show mainly as background noise, or what is sometimes to referred to as a “household soundtrack.” Snarky witticisms and sexual banter proved to be the perfect sounds to mindlessly distract myself from mundane chores. It is a formulaic show, one that you can start watching at any point in the series (or within a given episode for that matter) without missing anything of substance.
House, like many, if not most, procedural dramas, has a very precise recipe that guarantees satisfaction.
We begin with the tantalizing teaser. Terminal Jill (AKA whoever the guest patient of the week is), suddenly falls to the ground after sneaking out to meet her bad-boy boyfriend.
After the dramatically haunting opening credits roll we enter the hospital where Dr. House greats us with his lovely scowl and some Vicodin. He interrupts Wilson – who was just in the middle of both treating and falling in love with his dying female patient – to “borrow” a thousand dollars and promise to stop making prank police reports under Wilson’s name.
Before you can ask yourself why the hell Wilson is his friend, House explains that the reason he cannot take Terminal Jill on as a patient is because he must first solve the mystery of why Cuddy’s skirt shows no visible panty-lines. Cuddy agrees to cut House’s clinic hours if he agrees to treat the patient.
House and his team go over Terminal Jill’s symptoms on the white-erase board. They all disagree on a diagnosis, but know it is not lupus. House orders some expensive and invasive tests.
House says, even though he hasn’t met her yet, Terminal Jill is lying about something. House tells Foreman that since he is black he should be the one to break into Terminal Jill’s house and search for clues.
Cameron, Chase and Foreman’s pagers all go off at once. They rush to Terminal Jill’s bedside. Terminal Jill seizes violently as she proceeds to vomit everywhere. Terminal Jill’s mother fearfully asks Cameron what this means. Cameron slowly turns to the mother and says: “It means it’s not asthma.” We fade to commercial.
We return to see House ignoring Cuddy as she yells at him for ordering a dozen costly tests and procedures without getting permission. In fact, not only has Terminal Jill fallen into a coma, but also her parents are threatening to sue the hospital.
House sees a woman carrying a baby out of the corner of his eye. Now he’s got it!
House reveals that Terminal Jill has acute disseminated encephalomyelitis. He explains that he knew Terminal Jill was lying about not having a job when he saw the watch her boyfriend was wearing and assumed she bought it for him as a 3 month anniversary gift. She obviously acquired this as a result of an immunization shot that she got in order to start a babysitting job that she lied to her parents about because they are the leaders of the anti-immunization movement in town… see? Everyone lies, but the House always wins.
Forget for a second whether or not the diseases are real or procedures and tests were accurate. Sure, House has medical inaccuracies; in fact it is full of them. But before I bore you with a list, lets first look at the manner in which House came to his brilliant diagnosis, and his general actions along the way.
No, it is not his fondness of narcotics I care about.
House’s hunt for a rare disease and administration of numerous expensive tests and painful procedures labels him, what is known in the medical lexicon as a “zebra hunter.” Essentially, this is when a doctor ignores the first lesson taught in med school for identifying diseases, “When you hear hoof beats, think horses, not zebras.” Meaning, “common things are common.”
While it is possible for a patient to have a rare disease that presents itself in an unusual manner, it not possible for a single doctor to harbor all the knowledge necessary to rule out all common and rare conditions possible and confidently come to the correct diagnosis.
The illusion of the all-knowing zebra-hunting doctor is quite dangerous. Many doctors, including Dr. Scott Morrison, a family physician who reviewed the show on his own blog, report how more and more patients come in saying they think they have a disease they saw on House.
Such patients demand the same series of obscure tests they saw on the show. Morrison says this is just one example of the “House effect” putting him and other doctors in a bad situation. Not only are ill-informed patients self-diagnosing, they come in with unrealistic notions and expectations. This misunderstanding of the true limits of modern medicine can not only crush one’s expectations for a miracle, but also prove unnecessarily expensive.
Mental Context – A Delicate Subject
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