Wednesday, 14 September 2011

House, M.D.

Ever since St. Elsewhere -yes, I am really, really old- I am addicted to hospital series, from ER to Grey's Anatomy. My favourite, since I like caricature, and the overt references to the House of God, is Scrubs. There are more series, and one of them is annoying beyond description: House, M.D.. Apparently nobody shares my dislike.

Why do I have a problem with this particular series?
  1. House simultaneously works as a paediatrician, gynaecologist, nefrologist, gastro-enterologist, radiologist, surgeon, et cetera. For some reason his hospital does not need medical specialists. Internists do know alot but those I have met never attempt to be any other type of physician.
  2. Oddly enough, his diagnosis will ignore more obvious possibilities, and instantly requires us to accept a more unlikely scenario.
The first point should be self-evident, the second I will explain in more detail. Let me be absolutely clear, in no way am I suggesting the presented diagnoses are incorrect. One can argue that technically every episode is medically possible. Whether the sequence of events is plausible is something else.

From experience I can tell you that the series explores medical conditions that rarely, at initial presentation, offer sufficient information to instantly suggest their highly unusual diagnoses. The list of enigmas, i.e. uncommon diagnoses, I encountered consists of:
Only carotenaemia (jaundice without yellow eyes), and fièvre boutonneuse (eschar), were an on-the-spot-diagnosis, the others involved extendsive investigations. Eventhough I worked in highly regarded hospitals, no physician was able to pull any rabbit out of his hat. House, of course, would have known the answer within seconds. Utterly unrealistic, especially those that invlove a diagnosis per exclusionem, it is ridiculous to let House skip the exclusionem part.

Add to that the convoluted, and at times incomprehensible, decisions and you understand my being underwelmed. In all honesty, his diagnostic and therapeutic approach are so aberrant it immediately removes any credibility for me. Even the caricature Scrubs has an air of authenticity.

His Asperger-like antisocial personality I find less offensive, it resembles many physicians I have worked with. Totally incapable of thinking of others, and convinced of their infallability. Admittedly, like House, they do tend to know their stuff. Strangely enough this part of the character is true to life.

His magician-like ability to conjure up the right answer out of thin air makes me incapable of watching the series.


  1. With regards to your first point, the character Gregory House is a board certified specialist in nefrology and infectious diseases. His previous team consisted of Foreman (neurology), Chase (cardiologist and intensive care) and Cameron (immunologist). Still, this does not cover most specializations that are relevant to the series, so you do have a point.

    For the second point, House often takes cases no other doctor has been able to solve. He usually assumes they have excluded the likely diagnoses. Then again, House also assumes that most other doctors are intellectually inferior and basically morons, so he contradicts himself by not testing for the most probable things first.

    1. Thank you for your comment. As you may have noticed I have had little time to write new post. Will explain more in a seperate post but suffice it to say it involves emigrating and becoming a parent. :-)


  2. Surely a little naive and simplificated but that's what gives it entertainment value and makes it possible to watch these with my wife although she has no idea what Ogilvie syndrome is. And then, seeing the diseases I will probably never encounter in my whole life leaves some learning points and I have learned a few pearls from House and other of same kin. Like when Gray's thought she had cyanosis and it turned out to be a side effect from Cordarone, I will now never forget that!

    Cheers, nice blog.

    David, Sweden