House, MD: A Fabergé Egg of a Series

It begins with the word on the page. The writer. The words. Upon hearing the news earlier this month that he had been honored with a third successive Golden Globe nomination, Hugh Laurie, star of House, MD and himself a writer (novelist, screenwriter, and comedy writer), said in his usual eloquently humble way: "I'm extremely honored to be included in such company. But I have to emphasize how much I owe to David Shore and all the writers. Without them, I wouldn't even know how to finish this sentence without… you know…" Point taken!

One of the joys of watching House, MD is experiencing the intricacy and subtle layering of the writing. Laurie once referred to House scripts as "Fabergé eggs", and I think I do understand what he means. But speaking of Laurie, his nuanced and complex (and often brave) portrayal of the troubled House makes the writers’ words come alive and lends to them a resonance that beckons the viewer to look behind and inside and around them. The subtext he provides to the writers' words (and enhanced by the direction) lend a humanity and fragility to the character that is simply stunning at times.

If you think about it, so much is going on in even an average episode of House, it’s amazing that they can carry it off in the allotted 43-minute run-time. Pulling it off, creating the density, the pacing, and the ebbs and flows requires cohesion of script, direction, editing, and acting. Frantic action in a very talky, serious, funny show: breakneck action inter-cut with moments of exquisite introspection, soul-searching and ethical debate. When it works, the results are spectacular. And on House, it works (almost) always.

The season one episode "Sports Medicine" happened to be playing on my television the other evening. Written by John Mankiewicz,“Sports Medicine” fits into the “typical” House episode formula. But when you look into the heart of story, there is so much more going on than immediately meets the eye. Plots and subplots that move the series’ storyline forward, give us pause, make us think and make us laugh. It is quite intricate and fragile. Like Hugh Laurie said — a Fabergé egg. Yet the episode’s story can also be taken at face value, by a more casual viewer and be amusing and completely satisfying.

The constant in every House episode is its medical mystery. It is the medical mystery that creates the series' "procedural" elements. A patient comes in with symptoms that point to several things; House and his team enter into a cycle of diagnose/treat/diagnose/treat as the patient worsens; House gets an epiphany, and synthesizing what he and his team have been doing with his epiphany, solves the mystery and cures the patient (most of the time.) This "formula" is at the heart of much criticism of the series by those who call it too predictable — "formulaic". Most of the series’ episodes unfold in this way, with some notable exceptions. But rather than a negative, I view the the main medical plot as a constant in each episode, the skeleton upon which everything else is layered to create the dense, elegant, and complex character study of Dr. Gregory House.

Sports Medicine

In “Sports Medicine,” a mid-season one episode, a star baseball pitcher (Hank Wiggin) has broken his arm by simply throwing a ball (in one of the most difficult-to-watch scenes in the series). House’s immediate diagnosis is steroid abuse, which then becomes Addison’s disease plus steroid abuse and then ultimately (after some twists and winds) cadmium poisoning from tainted marijuana. A simple, straightforward (okay, nothing on House is ever completely straightforward) story.

Monster Trucks and Cotton Candy

At the end of the episode, Houses attend a “Monster Truck” rally with Dr. Cameron. The planning of his outing, which threads in and out through the episode, at first appears to simply provide comic relief. And I have to admit that House obsessing about a monster truck rally, paying $1,000 for tickets, and acting like a 10-year-old boy who’s getting a Wii for his birthday is pretty amusing to watch. But this seeming side-plot becomes the vehicle (as it were) to elaborate on the character of House, and to provide entry for several crucial character threads to be explored later in that, and other, seasons.

If you closely observe him (rather than only take him at face value), House is an intellectual. His knowledge base includes history, philosophy, classical music, and several languages, in addition to a broad understanding of the sciences. He has a vast library in his home. But he has a thing (okay, not just a thing, but a thing) for monster trucks, a very "red-necked" pursuit, that is seemingly at odds with what we expect of an intellectual — but completely in keeping with his well-maintained anti-intellectual, low-brow (in all things but medicine) image. It’s such a “guy” thing, and one that it’s hard to imagine the dour and miserable House getting all excited about. But the gleam in his eyes when he asks Wilson to share this treasured outing is a priceless moment in the series. One of the things that makes the character of House so utterly compelling and so very human is his inner contradictions.

Wilson, however, turns House down with the excuse that he must present an important lecture on the night of the rally. And the story of the Wilson lecture becomes yet another layer of the episode. And it provides the entry point for one of the most important storylines in the entire series.

House learns that Wilson, in fact, does not have to deliver a lecture on monster truck rally night. Instead, Wilson has lied to House, having cancelled the lecture in order to have dinner with someone named Stacy. This is the first mention of this important character, and she is clearly someone who both House and Wilson know well. Is she the woman House once "lived with" that he describes to Cameron, when she asks if he's ever been married?

Wilson feels that he had to lie to House about having dinner with Stacy, and House’s reaction suggests that something about House and Stacy's relationship was very painful, something about which he feels some profound sadness. Is it possible that House's unemotional, cold exterior masks very deep feelings, feelings that House’s demeanor suggests are far from resolved? We also observe how House reacts to Wilson lying to him. Wilson lying to House clearly hurts him (played so gorgeously by Laurie in those couple of scenes) more than angers him. Neat, huh?

The monster truck plot also reveals House’s social awkwardness with the opposite sex. Far from the leering, hooker-using, arrogant guy we may think he is, House’s shyness in asking Cameron to go with him to the rally suggests (along with the Stacy story) that House is a lot more vulnerable and fragile than we’ve been led to believe thus far. But his interactions with Cameron at the truck show also suggests that House is capable of being playful, having fun, and enjoying himself.

Dr. Gregory House, Rock Star

There is yet another side plot, this one involving Foreman, a new pharmaceutical company sales representative and, ultimately, of course, House himself. Foreman and the sales rep are having an affair. (Interestingly, setting up a comparison between the socially inept House and the more polished Foreman.) But the question is raised as to whether the beautiful rep is actually using Foreman to get closer to House. As House suggests, people get close to “Mick” (of Rolling Stones fame, of course) by forging alliances with his roadies. Turns out that she does actually want to get House to attend a conference through her relationship with Foreman, suggesting to the viewers (obliquely) that House must be quite a medical catch. I think that this is the first time we get this suggestion of House's importance as a physician from someone other than a colleague. Like the relationship reveal regarding Stacy, it makes the viewers wonder whether House might have lived a different sort of life before we meet him in the series pilot.

Patients’ Rights and Other Ethical Dilemmas

Like many episodes, “Sports Medicine” raises ethical issues. First, there is the question of Lola’s (the patient’s wife) willingness to abort her fetus in order to donate part of her liver to her husband. Although she is willing to do this to save her husband's life, Wiggins is opposed to the idea, going so far as to attempting suicide to make his point. After the suicide attempt, House is convinced that the patient needs to retain his control over the situation, and despite Lola’s and House’s team’s protests, House protects Wiggin’s right to make this decision. This is an issue that has been explored more than once on House — a patient’s right to die. It is a central theme on House, as it relates to House’s personal experience, which the audience learns more about several episodes later (in "Three Stories").

In the end, House also does something professionally unethical, but, perhaps morally right (another central theme on House — doing what is "right" but not necessarily "correct" or proper). After learning that the patient is a victim of tainted marijuana, and knowing that the diagnosis appearing on his chart will essentially end the ballplayer’s career, House omits this diagnosis from the official chart, instead sticking with his original Addison’s Disease diagnosis "for the record." He admits it to Cuddy, along with the explanation that no one should have to be destroyed because of one mistake. And omitting the information from the official chart allows Wiggin, at the height of his career, and soon to be a new father, to have a second chance. It’s a romantic action, and one not without professional risk to him, coming from this most (outwardly) unsentimental of characters. And it reveals an important character trait of House that is revisited throughout the series.

All of this packed into forty-three minutes. And I haven’t even included the comic relief of the episode (wherein House diagnoses an entire waiting room full of people in about 70 seconds!). And, as I suggested at the outset, “Sports Medicine” is a “typical” House episode. A good episode, but one that fits neatly into the formula, tries nothing extraordinary or out-of-the box. But it is this richness inherent in every episode, even the average bread-and-butter episodes, that makes House a truly great show. For at it core, House isn't so much a procedural, as a character study — and what a character!

The series writers — David shore, Lawrence Kaplow, Thomas Moran, Peter Blake, Sara Hess, David Foster, Russell Friend, Garrett Lerner, Mankiewicz, Matt Witten, , Liz Friedman, Doris Egan, and the rest — have, indeed, have created a beautiful, fragile Faberge egg of a series, wrought of silver filigree, fast-paced dialogue, and the rich inner life of a character brought so indelibly to life by a brilliant actor.

Happy new year to all, with a special wish that the WGA deal with David Letterman's World Wide Pants production company will pave the way to a resolution of the writers' strike!