February 2, 2007
The Appeal of 'House'
Recently I've had occasion to catch a few episodes of "House, M.D." At first I enjoyed the show as being analogous to the Sherlock Holmes stories: a central character with plenty of eccentricities, but with abilities that tower over all those around him, and we get to watch his deductive thought process. But after seeing a couple of episodes to completion, I was puzzled at the formula's conclusion. In Sherlock Holmes, the moment that we are made aware of the solution, the reader is instantly transported back to the clues and odd happenings that are so cleanly explained by it, the importance of the clues having been masterfully hidden from the reader's attention when they were introduced. We therefore experience our own incredibly satisfying 'aha' moment.
In a typical episode of House, the doctors go through a series of brainstorming sessions about what malady might be affecting the patient, interrupted by tests and procedures that confirm or deny hypotheses and provide another data point. Usually the picture seems to grow cloudier with each test, and the doctors knit their brows a little more in trying to come up with a new explanation that fits all the data. Finally they have some epiphany and the problem is solved. But for me, without any medical knowledge, there is no analog to the Sherlock Holmes moment--I have no idea why the solution is correct, or why they couldn't have thought of it before.
Can it be that the primary audience of this show is doctors, who might have a chance to experience the show the way I experience Holmes? Doubtful--doctors with the appropriate knowledge of infectious diseases would make a tiny audience in TV terms, and it seems unlikely that House is the first medical drama ever to be rigorously correct in its portrayal of medicine. It mystifies me that a show that is both popular and respected would have what I perceive to be such a central flaw in its premise. I suppose the explanation is that for most people, the characters on the show and their human drama are the main draw.
I recently posed my quandary to my old friend Al, now a fourth-year medical student. He was able, with his knowledge, to put the problem in a different light. Everything on the show is done backwards, he said. The doctors order thousand-dollar scans only to find out the problem is something that in reality they should have found during the basic physical exam as soon as the patient was brought in. Al said the only medical show he finds bearable is "Scrubs."





