Dr. Gregory House (flawlessly portrayed by Hugh Laurie in House, MD) avoids patient contact like the plague. “Unless it is the plague,” as House’s former lover Stacy once quipped (“Three Stories”). So, why does House avoid his patients so assiduously? As the doc himself would say, “Thanks for playing.”
House does not want to connect with his patients. “Treating illness is why we go into medicine; treating patients is what makes us miserable,” he announces to his staff in the pilot episode. And dealing directly with patients probably does make House miserable. Hating to be viewed as vulnerable, sensitive, or with any sort of chink in his cynic’s armor, when House finally does meet certain patients, his natural empathy takes over.
And it is with those patients — the gravely ill people who come to him as their last and best chance — that House communicates as wounded soul to wounded soul. With a main character so occasionally over-the-top – crude and adolescent, bitter and cynical – these moments help to balance the series so beautifully. With a character so utterly guarded, those moments (few and far between as they are) allow us a rare glimpse into House’s heart.
It is meaningful in understanding the character of House that it is usually (and almost exclusively) in the presence of strangers, patients who will soon walk out of his life, that House lets his guard down enough to commune heart to heart with anyone. The notable exceptions are Stacy (the love of his life) and Foreman, who at the time was his patient (and for whom House felt responsible).
The following is a guide to the some of the most powerful of those wonderful “House-patient” moments, in my most humble of opinions. It isn’t comprehensive, but they are among my favorites.
Pilot episode: In a scene towards the end of the episode, House, who has spent years avoiding patients, must confront a patient who is refusing treatment. With great difficulty and initial awkwardness, House appeals to her on an elemental level in a powerful speech:
“I just want to die with dignity,” the patient resolutely explains.
“There’s no such thing,” House passionately implores. “We can only live with dignity.”
She doesn’t accept House’s impassioned reasoning, preferring to die. And House accepts her decision. It was the moment I fell in love with the character and the show.
"Socratic Method" (1×06): There are several poignant scenes between House and the patient (Lucy, who is believed to be insane). House is so drawn into Lucy’s situation that he sits at her bedside at one point reading her poetry from Yeats. However, the best moment comes after House has been softly conversing with her for a bit. Lucy is trying to explain that she’s not crazy and plaintively declares, "Nobody believes me."
House quietly tells her, “I believe you.”
The second best moment is when House realizes that Lucy has, herself, called social services to come for her son, essentially reporting herself to authorities as an unfit mother. “Good for you,” he tells her as he realizes that Lucy’s clear-headed action eliminates insanity from the diagnosis. He later accepts the son’s wrath, allowing the kid to believe that he reported Lucy to social services, keeping Lucy’s secret. House is right, by the way. Lucy is not crazy. She has Wilson’s disease.
"Poison" (1×08): I think this is the only time House has had one of these moments with a clinic patient (not counting children who come into the clinic, with whom he always has a superb bedside manner). Georgia, who has come into the clinic with her annoying middle-aged son, has (it turns out) syphilis. She’s had it since she was young (much to the disgust of her son.) Over time the disease, now flared up after 50 years or so, has caused a type of damage to her cerebral cortex, stimulating the pleasure center of the brain.
Her libido heightened because of the illness, she hits on House, even writing him poetry. She has declined the antibiotics House has prescribed, preferring, instead, to “feel young” for the remainder of her aged life. House convinces her to take the meds by sweetly telling her that he would never prescribe anything that would prevent her from flirting with him. Of course it’s a lie, but possibly the kindest unnecessary thing he’s ever done for a patient. It may just be the single sweetest moment in the entire series.
"Control" (1×14): When the patient, Carly, finally meets House in person, he has determined that she’s a cutter and bulimic. Her drug of choice (Ipecac) has destroyed her heart. She needs a transplant. Her bulimia makes her a poor candidate. “It’s right up there with suicidal,” House explains. The only way the transplant committee will consider her is if he lies, risking his medical license and career. He wants to know from her directly if she thinks that she is worth it. “I want to know what is right,” he explains, so that he knows that whatever he does it is “the right thing.” (Doing “the right thing,” we find out in a later episode is a defining aspect of House’s persona.) “Stop hiding,” he tells her.
“What do you want me to do, cry?” she asks. He pleads with her to give him something to go on – some bit of information to let him know that he would be doing the right thing by taking the professional risk. He ultimately lies to the committee, securing her transplant. This scene is my proof that House isn’t in it merely for the puzzle. The risk he took here was well past the puzzle-solving stage.
"Babies and Bathwater" (1×18): The most unforgettable moment in this conclusion to the Vogler arc is House’s last minute impassioned plea to Sean (the patient’s husband) to let his wife die in order to save the son. Naomi (the wife) would have died in any event, and by appealing to Sean, calmly but passionately, compassionately yet honestly, Sean was able to at least have Naomi’s son. Sean is desperate and indecisive, yet with no time to make a life-or-death decision. House’s calm insistence and quiet passion convinced Sean, ensuring that the bereaved husband would not suffer the dual loss of wife and son.
"Autopsy" (2×02): House explains to the young terminal cancer patient Andie that she needn’t go through yet another series of invasive tests and surgeries in an effort to eke out one more year in life. In a powerful combination of House with a patient who is also a child, this scene is practically legendary for the punch it packs. House reveals to the cancer patient that the choice is hers; that she’s earned the right to live… or to die. The choice, he tells her, is no one else’s to make.
"All In" (2×17): It’s a simple scene with almost no dialogue, but House, at the end of his diagnostic and emotional rope, is out of answers regarding the young and quickly dying Ian. Mid-diagnostic session, House suddenly excuses himself from the futile debate and retreats to Ian’s room. Silently perched on the boy’s bed, House stands vigil, almost as if simply by being near the boy, the answer will materialize. It does not. Cuddy walks in on the scene, and as angry as she is with him at that point in the story, you can see her heart break as she can do nothing for the desperate House or their patient.
"Euphoria II" (2×21): Foreman is House’s de facto nemesis on the series (even if he is House’s subordinate). Foreman, gravely ill and in intractable pain, pleads with House to do a very dangerous diagnostic brain biopsy. House, feeling responsible for Foreman’s illness, equally pleads with Foreman to give him time to find an alternative that doesn’t risk brain damage. “Pain makes us make bad decisions,” House acknowledges. “Fear of pain is almost as strong a motivator.” We understand, as people who have come to know House, that he is likely referring to his own experiences. This reveal is almost as emotionally naked as House has ever been.
"Forever" (2×22): House appeals to the dying mother, who has, in a fit of insanity caused by her illness, killed her own son, to allow him to treat her. She refuses. She wants to die, or rather does not want to live with the terrible guilt she now bears. “You don’t deserve to die,” House implores. “And I don’t want to live, either,” answers the grieving mother resolutely. House accepts her answer, despite Foreman's insistence that they push harder. House dismisses Foreman’s suggestion. House is granting her the opportunity that he, himself, was denied after the infarction that ruined his leg: the right to die.
"Lines in the Sand" (3×04): “That was a 10,” Wilson tells House after Adam, the autistic patient gives House his precious video game handheld. And it was. Even though House dismisses the importance of the moment, hours later, standing vigil as the carpet installers replace his carpet, he still clasps the gift in his hand.
"Merry Little Christmas" (3×10): A woman with dwarfism has learned that her daughter, whose illness is mistaken for her mom’s disease, has raised her teenager to believe that she is better off being, as House tells her, a “freak.” “Being a freak makes you stronger. But how strong do you really want to have to be?” House asks the mom sadly. House is barely hanging on himself. Two scenes later he overdoses on Oxy and alcohol. House is strong, but the strain and pressure had been too much for even him to bear.
"One Day, One Room" (3×12): He doesn’t want to even treat this patient, a rape victim, but she will not speak to anyone else. And she simply wants “to talk.” To House. And only House. In an incredibly rare moment of vulnerability, House reveals that he is a child abuse survivor. The reveal prompts Eve to “talk about” her rape. While everyone else believes that “talking about it” is a good thing, House ultimately is not so sure.
Season four is new (and may, in fact, be cut short after 12 episodes). With the chaos in the department, hiring fellows, etc., we haven’t had much time for one of those hits-you-in-the-gut House-patient moments. Hopefully we’ll get one soon.
NOTE: The Writer’s Guild (WGA) strike is now in its second week. (Remember — support the writers — don't download episodes of this or ANY series till the strike is settled.) And there are still several new episodes of House to be aired. However, it may soon be an opportune time to dig out your season one through three DVDs and have another peek. This time through a slightly different lens. (Of course, even if the strike is settled tomorrow it's always fun to re-watch any House episode.)