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Hippocrates v Maimonides: The Ethics of Dr. Gregory House, Part II

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The question posed at the end of part I of this series was whether Dr. Gregory House, central character in House, MD, practices medicine within any sort of ethical framework. Often accused of being unethical, and certainly uncaring, House claims to eschew the Hippocratic Oath, medicine’s sacred ethical charge. Much of what we see of House “caring” about patients, or anyone else for that matter, is played out in the subtext, most often revealed in the brilliant non-verbal acting of series star Hugh Laurie — through his expressive eyes and body language.

Although House seems to possess little regard for conventional ethics, I have come to the conclusion that he actually does operate from a reasonably well-defined set of ethical principles. Leading me to wonder further if the well-read House is familiar with the medieval philosopher Maimonides.

Maimonides is considered to be one of the greatest philosophers and thinkers of all time. A Spanish Jew who migrated to Egypt, he is revered as perhaps the greatest of the post-Biblical rabbis. His works include not only religious texts and commentaries, but treatises on logic (he was a rationalist), ethics, and medicine (he was also a renowned physician).

Maimonides is credited with a physician’s oath (actually the attribution is disputed by some), which presents several guiding medical principles. The ethical framework suggested by the oath is one that might resonate with our good, but grouchy, doctor:

May the love for my art actuate me at all time. If nothing else, House is passionate about the medicine; it certainly “actuates” him — it’s what keeps him going and what he lives for. It is, in essence, House’s lifeblood.

In season one, when Foreman has the opportunity to go back to work for his old mentor, "Dr. Marty" (as he is called by House), he notices a "difference in their styles." Dr. Marty is a laid back, but eminent, LA physician. Foreman sees him as forgiving and reasonable, two things that he clearly does not see in House. Admitting that Dr. Marty is a good doctor, House illuminates the real difference between them: “He thinks you do your job, and what will be, will be. I think that what I do and what you do matters. He sleeps better at night. He shouldn’t.” It's a defining moment early in the series, revealing House's passion for medicine — and what he sees as the importance of dedication to its practice.

Medicine seems to haunt House in his every waking moment; he can seldom turn it off (except when watching monster trucks or General Hospital, that is!). And, despite the fact that he claims chronic laziness, eschewing work (especially in the clinic) as if allergic to it, the medicine and his love for it probably is the only thing that motivates him to get out of bed on those days (as he told Detective Michael Tritter in “Words and Deeds”) when the pain is so bad it “sucks the soul right out of you.”

On the other hand, House’s love for the “art” of medicine, makes him avoid who he considers the boring, everyday patients in the clinic. And House does spend a lot of effort avoiding the dreaded clinic duty, seeing patients who can be equally well-served by a “monkey with a bottle of Motrin,” as he ranted in season one’s “Occam’s Razor.” However, once he’s in there seeing clinic patients, House usually becomes engaged (“actuated”), and does take the necessary time with patients, occasionally more than another doctor, pressured by a full waiting room and time constraints, might.

May neither avarice nor miserliness, nor thirst for glory or for a great reputation engage my mind. One thing is certainly true, and that is that House is not motivated by avarice, the thirst for glory — or his reputation. And although season three's Detective Tritter may have been right in some respects about House’s relationship with drugs, he certainly was way off base in suggesting to Chase that House went into medicine because of the power it brings him. He couldn’t have been more wrongheaded.

Avarice? Despite House’s preference for expensive vintage guitars, no one could rightly accuse him of materialism and greed. (Okay, so he did awfully much like that vintage Corvette that the Arnello brothers gave him in “Mob Rules.”) He is not in medicine because it’s going to make him rich. In season one, the new hospital board chairman Edward Vogler orders House to lay off a staff member to cut costs. Agonizing over a way to avoid cutting anyone at all, House proposes cutting the salaries of the entire diagnostics staff, himself included: "Seventeen percent across the board will allow you to keep us all for the same amount of money. I believe it’s what you suits call 'win-win.'" It’s nearly a throw-away line, but the fact that House is willing to cut his own salary by 17 percent along with his staff salaries, says much about him, and the importance of money. Unfortunately, for Vogler, it was less about money than power — Vogler's.

House has little regard for his own reputation, and it's certainly not what drives him. It’s more than that he doesn’t care if people like him (or even respect him). If it is a choice between his reputation (or career) and serving the patient’s best interests (as he sees them), his reputation always loses. It’s not nobility; it simply doesn’t enter into the equation for him.

We’re aware from the very first episode that House is a doctor of some renown. “Your reputation still means something to this hospital,” Cuddy tells him in the series pilot. Clearly much of that reputation is for his particular gifts in diagnostics; however, as Vogler said to a cardiology gathering in season one’s “Role Model,” House also possesses a well-known reputation for integrity.

When given the option in “Role Model” to salvage his team by delivering a speech promoting a new (and not improved, but much more expensive) drug, House initially agrees to do it. But he struggles over the decision, telling Wilson that he’s selling his soul. “He’s not ordering you,” Wilson reminds House. “He gave you a choice. You chose your staff. I know this isn’t easy for you. You’ll suffer. Vicodin sales in Jersey will triple. But you are doing a good thing. Only you could feel like crap for doing something good.”

House tries to walk a fine line between saving his staff without selling too much of his soul, but in the end, he simply can’t do it, and instead of extolling the virtues of “Viopril,” House delivers a scathing indictment of Vogler’s company and the entire pharmaceutical industry: “Whenever one of his drugs is about to lose its patent he has his boys and girls alter it just a tiny bit and patent it all over again. Making not just a pointless new pill, but millions and millions of dollars. Which is good for everybody, right? The patients? Who cares about them? They’re just so damn sick! God obviously never liked them anyway.”

A more contemporary take on medical ethics, developed by a consortium of American and European doctors, "The Physician's Charter" states that the patient's interests be served without regard to "market forces, societal pressures or administrative exigencies." This is certainly something House would buy into. One of House's favorite rants skewers doctors valuing their their own lifestyles — or the hospital's bottom line — ahead of saving lives.

May I never see in the patient anything but a fellow creature in pain. Hmm. This is a tough one. Admittedly, House sees much of what comes into the clinic through a somewhat misanthropic lens. People are idiots wasting his time by coming in with illnesses that can be just as easily treated by taking an aspirin. But what about patients who come to him (even through the clinic) who are truly ill; who have futilely gone to doctor after doctor, only to come onto House’s service as a last resort?

Hugh Laurie has suggested (in one of the season three DVD featurettes) that House is “an old soul, someone who has seen a great deal of human suffering.” And I think House’s personal history influences how he treats his patients and how he views his own job and the profession of medicine.

The hyper-aware House is able to perceive suffering in another human being, and although his reaction to it may be (to say the least) quirky, abrasive, and distancing, it does affect how he responds. For example, in season three's “One Day One Room,” House wonders throughout the episode what draws rape victim Eve to him, like a moth to a candle flame. "Why me? Why do you want to talk to me?" he asks her several times. Ultimately she tells him that she sees in his suffering a kindred spirit, someone who might understand her because he “hurts too.” I think House has that ability, and tries (usually pretty successfully) to relegate it to a distant corner of his psyche, while promoting himself as the biggest jerk on the planet. I think "jerk" is a much more comfortable place for House to reside.

When House allows himself to get close enough, he does see his patients’ pain. And every once in a while, a patient really gets to House; gets under his skin. He more than sees their suffering; he understands it. He’s been there.

House’s poignant conversations with frightened and perhaps dying patients have been a hallmark of the series from the pilot episode onward. “We can only live with dignity,” an impassioned House tells the dying Rebecca Adler in the pilot episode, “we cannot die with it.”

In the season one episode “Control,” House treats Carly, a young woman who needs a heart transplant. Unable to condemn her to death because she’s bulimic and therefore fails to meet the transplant criteria, “right up there with suicidal,” House lies to the transplant committee to get her listed. “They would have had to condemn that poor girl; I’m not sure I could have done that,” House tells Vogler after he learns that House may have concealed the patient’s exclusionary condition from the committee. (And yes, I'm aware of the serious ethical issues involved — as someone else's patient may have died in order to give Carly a heart.)

In the season two episode “Euphoria,” Foreman has been infected by a deadly infectious agent after investigating a patient’s home. House pulls back on his usually aggressive medical approach, becoming cautious, “ordinary,” as Wilson accuses. Does the fact that it’s Foreman and not a stranger affect the way House approaches the diagnosis and treatment?

Most of the time, House puts himself so far distant from the patient that he objectifies them, enabling him to do whatever tests need to be done without regard to the patient's short-term pain and suffering — they're not people, they're patients. But Foreman can’t be objectified. He is not a nameless patient. He is Foreman, a subordinate, and someone for whom House is responsible. The fact that House is the one who sent Foreman into the lion’s den exacerbates the situation. When Wilson accuses House of being "common" and too passive in his diagnostic approach, House angrily asks him: “How many of your guys have caught cancer from their patients? Let me know when that happens. Then we can have this conversation.”

Later, as Foreman, still undiagnosed and now in terrible pain, wants House to perform a dangerous brain biopsy, House, baring his soul, tells Foreman a difficult truth, one House knows intimately and all too well: “Pain makes us make bad decisions. Fear of pain is almost as big a motivator. Now look, we still have time. I will do that biopsy if I have to, but not a moment before.”

Even when House does what he’s “supposed“ to do — like getting Eve in “One Day One Room” to “talk about” her rape — he wonders if he’s done the right thing. “Everyone will tell you,” he explains gravely to Wilson and Cuddy, “that that's what we gotta make her do. We have to help her, right? Except we can't. We drag out her story. Tell each other that it'll help her heal. Feel real good about ourselves. But all we've done is make a girl cry.”

Grant me the strength, time, and opportunity always to correct what I have acquired, always to extend its domain; for knowledge is immense and the spirit of man can extend indefinitely to enrich itself daily with new requirements. Today he can discover his errors of yesterday and tomorrow he can obtain a new light on what he thinks himself sure of today. House would be the first to acknowledge his own fallibility as a physician. But that doesn’t mitigate his feelings about the dire consequences of mistakes. As he tells Chase in "The Mistake", "Mistakes are as serious as the results they cause! This woman could die because you were too lazy to ask one simple question!"

As he tells a lecture theatre full of medical students in “Three Stories:”

I’m sure this goes against everything you’ve been taught, but right and wrong do exist. Just because you don’t know what the right answer is – maybe there’s even no way you could know what the right answer is – doesn’t make your answer right or even okay. It’s much simpler than that. It’s just plain wrong.

In the aftermath of Lupe’s tragic death (due to both human error and “some bad decisions”) in season three’s “House Training,” House is reluctant in the next episode, “Human Error,” to pull the plug on a dying woman. What if it’s something simple, he wonders; something they just simply “missed.” “If we do an autopsy, you'll see… oops… if I'd thought of that crazy idea, we could have saved her,” he explains to Cuddy. Not knowing doesn’t excuse or absolve you, but understanding what went wrong and correcting it adds to the medical base of knowledge, so that the next time, perhaps you do get it right.

Medicine is not an exact science, and that's why it’s often still called an art. House always needs to know the “why.” What did they screw up? What did they miss? When House insists on knowing, it’s not necessarily simple curiosity, but, as Maimonides Physician’s Oath states, knowing allows him to “discover his errors of yesterday and tomorrow he can obtain a new light on what he thinks himself sure of today.”

Now, I know that House is no knight in shining armor (I'd call him more of a knight errant), and his ethical lapses should not be minimized (and, if he were a real person instead of a fictional character, he would not survive very long in the real medical world). I also know that many fans of the series believe — and even applaud — the notion that House doesn’t care, and is simply in medicine to feed his “Rubik’s complex.” And for every example I’ve given there are counter examples to be had. And that's what renders the character of House so compelling. Uncaring bastard, who only cares when it serves his curiosity, or reluctant dark angel, who is compelled to fight off death and save the lives of the otherwise hopeless? Sometimes one; sometimes the other — but it certainly makes for a provocative television series, doesn't it?

And — speaking of provocative — the FOX official House site had posted three very interesting clips from the season five opener "Dying Changes Everything." However, the clips seem to have been removed. Hmmm! The season premieres Tuesday, September 16!

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About Barbara Barnett

Barbara Barnett is publisher and executive editor of Blogcritics, as well as a noted entertainment writer. Author of Chasing Zebras: The Unofficial Guide to House, M.D., her primary beat is primetime television. But Barbara writes on an everything from film to politics to technology to all things pop culture and spirituality. She is a contributor to the book called Spiritual Pregnancy (Llewellyn Worldwide, January 2014) and has a story in Riverdale Ave Press' new anthology of zombie romance, Still Hungry for your Love. She is hard at work on what she hopes will be her first published novel.
  • marykir

    Thanks for another thought provoking article, Barbara!

    Re. the Fox clips, I haven’t been able to see them yet in FireFox3, but they (still) show up fine in IE7. No idea how anything cached on my computer is influencing this behavior. Just thought I’d mention it :)

    Related to Maimonides – My local PBS station has been rerunning Cities of Light: The Rise & Fall of Islamic Spain recently (it’s also on DVD). If I remember correctly, there is at least a short mention of Maimonides. It’s definitely an interesting overview of that culture.

  • Barbara Barnett

    Thanks marykir. First I was able to see the clips, then not (both on Firefox 3). Now they’re back and have been joined by a fourth clip!

    I will try to check out Cities of Light as well.

  • Sue

    Barbara,

    This is one of your best interpretations. The comparisons to Maimonides are striking.

    House operates like he does because he doesn’t want to live with others’ expectations of him. This comes from the abuse he received from his father. As a military man, his father had expectations about how young Greg should conduct himself. I imagine that Greg had a hard time living up to what his father expected of him. So, rather than live like that as an adult man and as a doctor, House chose to be a jerk and live by his own rules. House set his own agenda. He doesn’t have to care about how people feel about him because he already told them he is a jerk. He doesn’t have to follow conventional medical guidelines, because he let everyone know he doesn’t care about that. He chooses his own goal, and he chooses his path to that goal. If something gets in his way, he charters his own course to get to the moral and ethical goal he believes is right. With no expectations, he wins every time.

    House realizes that he is not just teaching medicine to his fellows, he is teaching them a moral and ethical code. He doesn’t always share his techniques and ethical dilemmas with his staff. He realizes that he will go further than others, and he will leave them behind when he travels across that boundary. He doesn’t want to risk the reputations of his colleagues, but he will sacrifice himself for what he believes is right. Foreman did this in Needle in a Haystack, when he tries to convince the patient to get the experimental treatment and not tell his parents. He was willing to risk his license to help the patient.

    House is not “actuated” by all patients and their medical conditions. He shies away from the mundane and unremarkable, especially in the clinic. I don’t think it is solely out of boredom. He recognizes his incredible talent, and he does not want to waste his expertise on patients any other doctor could diagnose. It is not ego-driven. It is derived from his desire to do the right thing. House does not adhere to “practice guidelines,” which are a part of medicine today. He would not settle for doing what 95% of patients would require while ignoring the other 5%. House lives in the realm of that 5%, and his ethical and moral dilemmas are derived from how he can do the right thing for that minority.
    House lives in the “hole” of that 5%. Everyone around him is trying to get him to “come out of that hole.” (House vs. God)

    “May I never see in the patient anything but a fellow creature in pain.” Part of what makes House intuitive is that he does see the patient in ways other than as “a fellow creature in pain.” House sees suffering and says “I don’t care.” He recognizes their suffering, but he does not allow only that to guide his actions. House looks for what is underneath that suffering to find out what the patient is hiding, as Emma told him she does in Fetal Position. It is there that House often finds the answers he needs to treat the patient successfully. Often, the reason he fails initially is because he does not yet have the answers that lie beneath the surface. A good example of this is when he discovered that Carly was bulimic. If House had not discovered this, Carly might have gotten a new heart but she might have ruined that new one if the bulimia continued. House figured out that a patient was taking birth control pills to prevent pregnancy, while taking fertility pills to get pregnant. It was this discovery that allowed House to make the diagnosis and treat the patient successfully. Many doctors would see the patient in pain but not delve into the personality quirks that underlie the condition. Another example is from Humpty Dumpty. Cuddy only saw the patient as a fellow person in pain. She could not be objective. House did not care that they had to cut off his hand and he couldn’t work. The goal is not to sympathize with the patient, it is to cure him.

    None of this would work without the incredibly nuanced performance by the brilliant Hugh Laurie. It is a shame he cannot appreciate his own talent. He could never watch House MD and be mystified by his own characterization of House. But, he would be fascinated with the talent of the actor who played this character if he wasn’t Hugh Laurie himself. House is the most real character to ever exist on TV. The fact that people cannot imagine any other actor playing House shows the reverence fans have for Hugh. The multi-factorial and multi-dimensional aspects of House allow the writers to explore these ethical and moral situations with integrity and respect. Hugh takes the viewer on a ride they never want to stop. We crave these situations so we can delve deeper into the mind of this fascinating character. Neither the writers nor Hugh have ever gone the easy route. They continually surprise us with new situations and keep House’s interpretations unpredictable. “You either help the patient die or you help them live. You can’t do both.”

  • Sue

    I only saw 3 clips. Where is the 4th?

  • Barbara Barnett

    Sue–I’ll respond to your longer, very thoughtful response later this evening when I have more time–but to access the fourth, when the page comes up, click on “video” at the top of the vidscreen and it will come up. It’s a scene between House and 13. Very interesting exchange between them.

  • sdemar

    First of all, Barbara, that was another brilliant article.

    Consider me as a fan that doesn’t feel that House is simply in medicine to feed his “Rubik’s complex.” He is a healer and unlike the Dr that Foreman was interviewing with in Season 1, I don’t think House sleeps well at night at all. His mind is always working a case.

    I also think he goes out of his way to show us his obnoxious side so he can keep the noble side hidden from us. Like Cuddy, I believe House is worth having around. There is much more to him than meets the eye.

    I think he has shown us time and time again that he is willing to take the extra step for a patient. As you pointed out in one of your examples, to me, the greatest example was pleading his case for bullemic woman. He could have lost his license but what mattered more to him was giving this woman another chance. After she said she wanted to live,he was willing to take the risk.

    Thanks for the great read.

  • Grace

    WOW! Barbara, that was one great piece! I loved it!!
    If anyone watches HOUSE regularly, they must see that House cares. It’s always there in his eyes.
    Oh I just can not wait until Sept. 16th!!
    I love this show and I love this man.
    Again, KUDOS for a GREAT job!!

  • http://annuk ann uk

    Dear Barbara, thanks for another brilliant and thought provoking article. I have only just read it and still need time to digest it, but two things spring to mind : 1) anyone who writes House off as a “jerk” activated only by cold-blooded curiosity , hasn’t been paying attention ( and you do have to pay attention to this show where every detail has meaning )2) every thing Sue says about Hugh Laurie is true and like her I am sorry that he seems not to recognise his own genius,but perhaps if he did he might start
    “acting” instead of “being” House.

  • barbara barnett

    Thanks all for your kind comments. So much of what we knowb of house’s heart and soul is in the performance.

    BTW–i’m workong on a new trivia quiz to posted sometimw today

  • Buds

    Superb article!!! Excellent stuff.

  • barbara barnett

    Thanks Buds,

    I’ve only got sporadic connection this week as I’m in the wilds of Alaska. This two-part article was interesting to research (and much gratitude–as I said in the first part–to the dilligent people at the clinic duty Live Journal, who maintain such fabulous episode transcripts!)

    It’s interesting that my husband, whose interest in the show really only extends to the fact that I like it, is quite fascinated with the morality/ethics of the show. His big issue comes up in “COntrol,” where of course by going the extra mile for Carly, who had an eating disorder, he was thereby denying a heart to some one who maybe also needed one, but might be considered more worthy. House couldn’t make that decision to deny Carly the heart. It is an interesting paradox.

  • Orange450

    Barbara, I hope you’re having a great Alaska vacation. My husband and I went two summers ago – also in mid-August. Our respective fiftieth birthdays and our twenty-fifth anniversary all fell in that calendar year – so we put the celebrations together into one big one. It was an unbelievably beautiful trip, and I’d love to go back.

    Thanks for this article. Wonderful, as usual! Rambam would be proud :-) I couldn’t help but smile at the thought of an analysis of House’s approach to life structured against the Thirteen Principles of Faith. That one might be a little harder than this!

    I agree that the “fellow creature in pain” is a tough one. As you indicated – House has certainly demonstrated that he’s capable of deep and surprising “fellow-feeling”, but I think it’s a selective response that’s only occasionally triggered by some specific set of circumstances. I guess it’s possible that his habitual manner masks something more comprehensive, but I’m honestly not sure.

    Before I came to your paragraph in Part I that begins “I’m not saying House is a good guy”, and as I was reading your lines about Foreman unwilling to “become” House – the words “collateral damage” came to mind.

    When Foreman says that he doesn’t want to become House, I understand that he’s talking about House’s manner – the abrasive harshness, the unfiltered directness, the “take no prisoners” approach – not necessarily the diagnostic style and skill. And so my question is – is it possible to practice medicine in House’s fearless and heroic style, while maintaining some level of consideration for the feelings of innocent bystanders? Because Maimonides, while an exemplary, exacting, and tireless teacher and thinker (with surprisingly modern ideas about the importance of good nutrition to general health!), was also a kind and considerate one.

    Could House be just as medically effective – albeit not nearly as interesting :–) – if he was a little nicer to the people around him? (Horrors! Perish the thought!! This is only a theoretical question! I love him just the way he is on the show, although I’m always glad to read your observations that he’s a fictitious character. To me he seems so much larger than life, and so much the product of supernaturally exquisite writing that I’ve never been able to relate to him as if he’s an organic personality. I was actually relieved when I heard a comment from David Shore that during the casting process, he worried that he’d created “a collection of characteristics that didn’t appear in nature”!)

    I just wanted to say one thing about House’s ethical framework. I agree absolutely that he operates in accordance with his own very strong one, which usually (but not always) resonates with me as the right thing to do at the time. But it seems so personal to him that it would be almost intransmissible (that’s not a word, is it?) to anyone else. I’m struggling with the idea that an ethical framework – in order to be beneficial – should be usable across a larger segment of the population, but I’m not sure. Time to take Philosophy 101, I guess. But it’s a tribute to the show that it provokes the question.

  • http://annuk ann uk

    Orange450’s comments on a universal ethical framework are very interesting. Every society needs a common ethical system to which most people accede or it could not function at all. In a civilised society these are at least partially incorporated in the law and in professional codes, but we also need the outsiders ,rebels and critics who make us question the accepted ethics, otherwise we would still be burning witches and owning slaves.
    In his own medical field House is the rebel outsider but his stance can only be justified because it works for his patients-a less able doctor needs the professional code to discipline his judgment.I think House feels that the code is too often used to protect the doctors’ “lifestyle” and not the patient
    So how much freedom should we give a rebel like House ? I’m afraid my philosophy breaks down here and I am reduced to saying it all depends on context,motive and results.
    Perhaps another correspondent can take it farther.
    What an extraordinary show “House” is to provoke such a discussion!

  • http://annuk ann uk

    PS I love him just the way he is too and Hugh has made him so real to me that I actually worry about him off screen ! As series 5 wont be shown here until 2009 , I shall have a long , anxious wait to find out what happens to him.Also I wont be able to read your comments on current episodes until I see them, so please give me some back numbers to bite on and some fan fiction too, if possible…..

  • orange450

    ann, I think you expressed it very well you used the terms “context, motives and results”. I also think the idea of “checks and balances” is necessary in *both* direcions. We need the rebels and critics who question the established ethical standards, and we also need those who protect them (generally personified on the show by the likes of Wilson, Cuddy and Foreman (with occasional assistance from the various ducklings). Ideally, the two forces working in an enlightened and wise synergy would yield the most durable and beneficial results. (Talk about a utopian fantasy! ;-))

    My heart goes out to you in your House-deprived state until 2009. Do you read spoilers??

  • Sue

    In Fetal Position, House said the next generation was not his patient. He decided to recommend aborting the fetus to save the mother. In Control, the patient who might have received the heart that went to Carly was not his patient. Part of what makes House able to take chances is that he doesn’t worry about the rules, the odds, medical guidelines, or what happens to patients that aren’t his. He does the right thing for that patient at that moment.

    House filters what he will allow other doctors to know about his methods and decisions. When he thinks something will apply to more than one patient, and if he is not blatantly doing something others will find unethical, he will use his actions as a teaching tool. And, not just as a “you could do this,” but as a “you SHOULD” do this.” House doesn’t want to leave his ducklings with the same things they could learn other places.

    In House’s mind, what makes a good doctor vs. a great doctor? House feels a great doctor takes chances and doesn’t sleep well at night. Why doesn’t a great doctor sleep well at night? Is it because he did not take enough chances to cure the patient? Is it because he did not break enough rules? Is it because he made the wrong decision (House Training)?

    From whose perspective do we judge House? Is it different if you are his patient or a relative of his patient? One of the ducklings? The hospital administrator? The patient who didn’t get the heart House lied about? Would House always be right if his decisions benefited us, yet always wrong if it didn’t? How much does religious affiliation affect our decision about him (One Day, One Room)? Would we do the same thing if we walked a mile in his shoes?

    Sometimes I wonder if viewers analyze House the character more than the writers do. How much of what we perceive about the character was pre-planned, and how much is from how Hugh interprets House? I’m think it is about half and half. Hugh’s body language, facial expressions, eyes and voice all contribute as much as the dialogue to make House so intriguing.

  • ann uk

    Orange450,No I try not to read spoilers tempting though it is.Thanks for your sympathy !
    I agree that the difficult, shifting balance between the accepted ethical code and the critical, innovating outsider is well expressed in House’s relationship with Wilson and particularly with Cuddy and even with the obnoxious Tritter.It is one more credit to the show that it doesn’t simplify this conflict.
    Yes, wouldn’t it be a Utopian world if it could always be resolved by sweet reason ?!

    Looking at history, it seems to me that there is always a price to pay for every serious moral choice, whether to do nothing or to do something and whether to conform to conventional ethics or to break them.
    All to often that price is paid by “innocent bystanders ” like the patient who didn’t get the heart or like the baby that died in “Maternity” ( series 1 ), but moral choices can’t be avoided and one of the admirable things about House is that he is brave enough to make choices other doctors avoid and doesn’t shirk the responsibility for them.

  • Orange450

    Sue asked:

    “From whose perspective do we judge House? Is it different if you are his patient or a relative of his patient? One of the ducklings? The hospital administrator? The patient who didn’t get the heart House lied about? Would House always be right if his decisions benefited us, yet always wrong if it didn’t?”

    I think that’s the whole point of an effective (I know, very subjective) ethical framework – to enable an unbiased platform for such judgement. From an ethical perspective, it shouldn’t make a difference whether you’re the patient, the relative, or the duckling. (Doesn’t mean you necessarily *like* the decision – but you should be able to recognize that it’s an ethical decision). The ethical rights and wrongs of a decision should be independent of whether or not we benefit by it.

    Sue also asked:

    “Sometimes I wonder if viewers analyze House the character more than the writers do. How much of what we perceive about the character was pre-planned, and how much is from how Hugh interprets House? I’m think it is about half and half.”

    I’ve asked that question too, but I think I know the answer. I don’t the writers spend a fraction of the time analyzing him the way we in the viewer community do. I think they think we’re crazy ;-)

    I’ve asked your second question too, and I agree with you – half and half sounds about right.

  • Barbara Barnett

    Hi guys…back from the north (spectacular). I do think we analyze the characters more than the series writers, although I think that (particularly House) the characters are written consistently enough that they do think about (for example) What would House do?

    I agree that House’s ethical framework is incredibly specific and based on his particular (and unique) knowlege, genius and experience. It’s not transferable without him. And that’s his value to cuddy. He’s a one-off.

    I think quite a lot of how House developed was driven by Hugh. His natural humanity, humility and compassion I really think do seep through the performance (along with his magnificent melancholy). This is why a different snarky-able actor would not work. too much is in the performance. But then the writers write for him now, knowing what he can do. Cool.

    How should House be judged. Is he REALLY doing the “right thing?” I think that’s a question that House continually asks himself. I do think he considers the angle and the risks and benefits (he can “do the math,” as he says). But I think he agonizes over those bold and brave strokes for which no one else is willing to share the responsibility. Like in Maternity. Cuddy says: do what you think is best. She trusts him, but is unwilling to know about it.

    Good to be back. Trivia answers are up; DVD review should be up later today.

  • http://annuk ann uk

    Welcome back I’m glad Alaska was great.I hope we are going to get a review of series 3 and 4
    as I shant see series 5 till 2009( see previous entry )and will have to restrain myself from reading your comments on it till I see them !

    I suspect the House team do think we are crazy. Do you think they even read the Blog ? But they wouldn’t be the first writers to create a character that lives a life of its own – Conan Doyle did the same with Sherlock Holmes.

  • Barbara Barnett

    Hi Ann–

    I will try posting episode guides like I did for seasons one and two sometime this autumn, as time permits. Oh…I do feel your pain about having to wait for season five! (Hey, I feel the same about Wire in the Blood!–and that’s only 6 episodes!)

    I will have my season four dvd review up later this morning as well.
    As far as the powers reading my blog, I’m not sure, but I do know that they have read at least some of my articles. As to whether anyone over at House reads this blog regularly, I would doubt it. Would be cool, though, huh?

    I don’t think the House team think we’re crazy, though. I think probably some of them have, in their lifetimes, had strong affinities for their own favorite shows to watch. It’s why a lot of TV writers got into writing tv!

  • Orange450

    Welcome back, Barbara. I enjoyed your Alaska article – it brought back wonderful memories of two summers ago. Some of my pictures look very much like yours.

    With regard to the writers, and whether or not they think we’re crazy – even though I don’t watch much TV at any given time, I’ve certainly watched my share over the years. There’ve been many series that I enjoyed, but House is a completely new phenomenon in my experience. The actors, writers, and TPTB have redefined the medium of television for me :-) Never in my life did I imagine becoming so invested in a TV character – to the extent of analyzing his every line of dialogue (not to mention his gestures and expressions!) in search of every possible shred of meaning. Never mind what the writers think – *I* think I’m crazy!

    But there was an interview with Leonard Dick published a few months ago, in which I think he mentioned something about being surprised at the intense analysis by some of the viewing community.

  • sue

    There are ways to view House episodes over the internet, if you can’t get them where you live. You don’t have to wait until they appear on your tv.

    What makes House intriguing is where his lines in the sand are drawn. At what point does he keep his intentions and actions to himself? Where does he draw the line with Cuddy? With his ducklings? With himself? When he scheduled the patient for the boob job, he kept the real reason he was doing the procedure from Cuddy to protect her and the patient. How much of what House keeps from her is to protect her, and how much is to keep her from interfering with what he wants to do? How far is too far to go?

    I too have been more interested and involved with this show than any other. I wondered why anyone would want to purchase a DVD of a tv program or movie. Once you have seen it, why see it again. I can watch House over and over again and never get bored. I call this show the “perfect storm.” It starts with Hugh Laurie, who makes every line he delivers unique in emphasis, expression, tone, facial expression, body language, sarcasm, snarkiness, inflection and every way possible. He embodies House in every way and makes it look so easy. Cuddy and Wilson are perfect foils for House. Lisa Edelstein and Robert Sean Leonard are exquisite in their portrayals of the characters that keep House grounded. The original ducklings were a perfect balance of class and character. The format and story lines advance the story and keep it moving and flowing. The new ducklings are the only kink in the chain. I just love this program.

  • Barbara Barnett

    What makes House intriguing is where his lines in the sand are drawn. At what point does he keep his intentions and actions to himself? Where does he draw the line with Cuddy? With his ducklings? With himself?

    There are times when he does “questionable” things that he keeps everyone in the dark–the autopsy on the dead baby in Maternity, for example. Sometimes he gets caught up in the medicine and while he doesn’t care about himself, he’ll occasionally ask one of the team to do something questionable. They will question him, which always respects–and then goes on to do it himself. But his team (and Wilson — as in Insensitive) do help to put the brakes on him–make him rethink sometimes.

    When he scheduled the patient for the boob job, he kept the real reason he was doing the procedure from Cuddy to protect her and the patient. How much of what House keeps from her is to protect her, and how much is to keep her from interfering with what he wants to do? How far is too far to go?

    He’s done that several other times. With gabe in SOCG; and this season in “Living the Dream.” those are two that come immediately to mind.

    I too have been more interested and involved with this show than any other. I wondered why anyone would want to purchase a DVD of a tv program or movie. Once you have seen it, why see it again.
    This is the only series tv show I watch with any regularity. Most of what I watch is news, movies, and more news.

    I call this show the “perfect storm.” It starts with Hugh Laurie, who makes every line he delivers unique in emphasis, expression, tone, facial expression, body language, sarcasm, snarkiness, inflection and every way possible. He embodies House in every way and makes it look so easy.

    No argument from me there! I think House’s natural humanity also comes through as a wounded vulnerability with regard to other patients–and sometimes his colleagues.

    The new ducklings are the only kink in the chain. I just love this program.

    They really started to grow on me towards the end of the season. They are very different from CCF, and present new challenges (and threats–from Taub in particular) that the old guys didn’t.