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House creator David Shore and Hugh Laurie nailed the tone and drama of the series right from the start!

TV Review: House, MD Season One Pilot (Revisited)

I’ve only been writing for Blogcritics since early this season, so I’ve never really had an opportunity to jot down my thoughts on the series’ brilliant pilot episode, which aired originally in the fall of 2004. The episode re-ran recently, and it struck me by the end of it how consistent the vision for the character of House series has been since day one.

We understand from his very first scene that House is a man uncomfortable in his own skin. He hides from patients; he hides from everyone. Is it laziness? Is House a slacker? Or is there something else? After all, we get the impression that he has been hiding out in his office for quite some time,avoiding work, avoiding his boss.

"People don't want a sick doctor,” he admits to Dr. James Wilson, who has referred a patient to him to lure him from his isolated existence. This single line, so quickly deflected into a joke, sets us up to forgive many of the not-so-likable things will learn about House as his story unfolds.

House declares that he hates people; he has no time or patience for patients. Besides, "everybody lies." He projects an image of arrogance and disdain, but with that one little line, so beautifully delivered, "no one wants a sick doctor," we understand where he is coming from. We understand immediately that this man is not only disabled, not only in great physical pain, but he hurts inside as well. And maybe those hurts on the inside are even deeper and more painful than his overt injuries.

It is clear that Wilson, House’s best friend, is concerned that House is wasting his gifts by not seeing patients, so for the first few episodes, Wilson manipulates him into seeing patients. This is only the beginning for Wilson’s manipulations, as they are a consistent note throughout the series.

To me, the medical cases are always less interesting than the character study of House. And my favorite scene of this episode (and is up there amongst my favorite scenes of the entire series) is his conversation with Rebecca Adler, the Patient of the Week (known in the House fandom as POTW) near the end of the episode. House reveals himself to her (as he often does, connecting on a visceral level with his most desperately ill patients) as he can't and won't do with his colleagues. I can't imagine that House has ever explained to anyone how he felt when he was at death's door; ever shared his internal pain so eloquently. But with her — a stranger — he can be honest and empathetic. These exchanges have become a hallmark of the series.

When House connects with patients, he believes that his emotions (perhaps about his own physical condition) get in the way of rational, empirical medicine. And judging from the season two episode “Euphoria,” he may be right. But that speech to Adler, starting off so haltingly, so difficult for him to articulate at first, becomes passionate and we know the emotional toll it has taken on House to do it. That feeling we get about House in the pilot remains true and consistent throughout the series’ three-plus years, as House’s most intimate character reveals often occur with patients (which is, at the very least, paradoxical for a character who is a self-described misanthrope).

House can’t afford to become involved with patients, Wilson says towards the end of season two. If he gets involved then he has to care; and if he cares, well… the game is up. Wilson, also true to form from the pilot on, has ever attempted to manipulate, cajole, lecture, and hound House into ridding himself of his affected indifference. I recently saw the film The Scarlet Pimpernel – the original – with Leslie Howard, whose foppish air of indifference masked a deep and dangerous humanity. I realize how much that reminds me of House. (Not the fop part, however. That's more Black Adder territory.)

But as far as the people who work with him know, House is an arrogant jerk, borderline racist, bitter, happily miserable, and a terror to his patients, colleagues, and hospital nurses. But, as Wilson admits in the pilot episode, caring has more to do with actions than words. “Does he care about you?” asks the patient, Rebecca Adler. Wilson can only reply that he “thinks so.” But Adler comes back with a retort that defines the entire series: It’s not what you say; it’s what you do. “Yeah, he cares,” Wilson finally acknowledges.

House has a particular empathy for the powerless (especially children) and people who are harshly prejudged. But his colleagues never see that side of him. Those scenes are carefully written to be out of sight of the series’ regulars. And have been from the pilot, as they must be. They don’t see House dealing with the strain and pressure of what he does; never observe him agonizing about the life and death decisions he has to make. As Wilson pointed out in last season’s finale “Human Error,” Foreman’s issue is with what he believes House to be; not who House is. House refuses access to this part of himself:  the man who fell apart after Stacy left; who sends sticky-sweet romantic notes, who wakes up on some mornings so much in pain that he seems on the verge of collapse. And the writers have been ever careful and consistent to keep him hidden (mostly). House hasn’t changed, but he remains consistently the same, as Hugh Laurie has said he must.

The pilot episode is so beautifully conceived, written, and performed that it’s hard to believe that they nailed it so completely in that very first episode. Yes, they hadn’t quite yet realized that Hugh Laurie would render the character so incredibly sexy; yes, they went a bit heavy on the CGI; yes, the lighting was orange (orange?); Cuddy was too severely dressed, etc.

But who could not be magnetically drawn to the cynical, sarcastic doctor who so completely emotionally bares himself to a dying patient as he does with Rebecca? Early in the episode Wilson tells her that House has motives other than caring that drive him to be a good doctor. (I’m sure he’s referring to House’s interest in “solving the puzzle.”) But in that final speech, the puzzle already solved, what other reason would House have to make so impassioned a plea, appearing so vulnerable in front of a patient? It is moments like this one, episodes like this one, when House briefly casts aside his affected indifference that make for some of the most compelling television out there.

New episodes of House return (sorry, folks, but it looks like there will only be three more episodes to the strike-shortened season) on January 29, and will then air February 2 (post-Superbowl) and February 5. Support the Writers’ Guild by NOT downloading episodes from the Internet. The writers get no compensation for those Amazon Unbox downloads. Buy the DVDs instead!

About Barbara Barnett

Barbara Barnett is Publisher/Executive Editor of Blogcritics, (blogcritics.org). Her Bram Stoker Award-nominated novel, called "Anne Rice meets Michael Crichton," The Apothecary's Curse The Apothecary's Curse is now out from Pyr, an imprint of Prometheus Books. Her book on the TV series House, M.D., Chasing Zebras is a quintessential guide to the themes, characters and episodes of the hit show. Barnett is an accomplished speaker, an annual favorite at MENSA's HalloWEEM convention, where she has spoken to standing room crowds on subjects as diverse as "The Byronic Hero in Pop Culture," "The Many Faces of Sherlock Holmes," "The Hidden History of Science Fiction," and "Our Passion for Disaster (Movies)."

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