House (2004–2012). Created by David Shore. Eight seasons, 177 episodes. Spoilers throughout.
First, Something Goes Wrong
Somebody collapses. It might be a teacher in a classroom, a teenager on a sports field, a musician halfway through a performance or an otherwise healthy person getting on with an ordinary day. Whatever the circumstances, the body suddenly stops behaving as it should. Doctors run tests, make a diagnosis, administer treatment and discover they have probably made everything worse.
Somewhere inside Princeton-Plainsboro Teaching Hospital, Gregory House is avoiding clinic duty, annoying a colleague or playing with something on his desk. Eventually somebody brings him the case. He insults everyone, suggests something improbable, gets it wrong, tries again and somehow arrives at an answer nobody else considered. As a weekly formula, it was almost absurdly dependable.
That was the basic machinery of House, the American medical drama that ran from 2004 to 2012. It sounds repetitive when reduced to its ingredients, and occasionally it was. But I still think it is one of the more interesting medical dramas from that period, largely because the man solving the medical mystery was every bit as troublesome as the mystery itself.
Hugh Laurie’s House was not particularly interested in being liked. He was rude, manipulative, arrogant and deliberately offensive. He treated hospital rules as suggestions and his colleagues as unwilling participants in elaborate experiments. Yet I kept wanting to watch him work, not because I admired him, but because he could solve almost every problem except the ones he had created for himself.
A Detective Story Wearing a White Coat
One of the things that separated House from other medical dramas was its approach to storytelling. Where ER concerned itself with the frantic movement of an emergency department, and Grey’s Anatomy built much of its identity around relationships between doctors, House treated illness like a detective story. The patient was the mystery, symptoms were clues and the disease was effectively the culprit.
The idea grew partly from physician Lisa Sanders’ Diagnosis column in The New York Times Magazine, which explored difficult real-world medical cases. Paul Attanasio and Katie Jacobs helped develop the project, David Shore created the series and Bryan Singer directed the pilot. Shore’s defining creative decision was to build his protagonist around Sherlock Holmes, a comparison that becomes impossible to miss once you start noticing the details.
Holmes solves crimes through observation and deduction; House solves illnesses by recognising patterns everybody else overlooks. Holmes has Watson as his companion and moral counterweight; House has Wilson. Both men are brilliant, obsessive, emotionally difficult and inclined to become unbearable when bored. Even House’s drug dependence and musical interests echo aspects of Conan Doyle’s detective, although the series never needed to present itself as an explicit adaptation.
What interests me is the consequence of getting a clue wrong. A detective might allow a suspect to escape; House can have a patient die on the operating table. The medical setting gives the mysteries an immediate physical danger, even when the science is plainly being stretched for entertainment. It also establishes an uncomfortable contradiction: the man who spots everybody else’s lies often seems completely unable to recognise his own.
The Doctor Nobody Would Actually Want
Hugh Laurie was an inspired casting choice, particularly for anybody who knew him from British comedy. There was something faintly absurd about watching a man familiar from Blackadder and A Bit of Fry & Laurie become one of American television’s most recognisable doctors. His American accent was convincing enough that Bryan Singer reportedly did not initially realise he was British when reviewing the audition, recorded in a hotel bathroom while Laurie was working on Flight of the Phoenix.
Laurie’s performance works because House is not simply an angry man with unusual diagnostic skills. He can be extraordinarily funny, but his humour generally has a target. He likes making people uncomfortable, partly because he enjoys the reaction and partly because discomfort can reveal something useful. He also understands, perhaps better than most doctors on television, that what a patient says and what the evidence shows are not necessarily the same thing.
His cane matters as much as the dialogue. An infarction in his right leg damaged muscle and left him with chronic pain and a permanent limp. His regular use of Vicodin becomes inseparable from his daily routine, affecting his relationships, judgement and eventually his grasp of reality. What the series does particularly well is refuse to make his pain a complete excuse for his cruelty.
House can be cruel because he is hurting, certainly, but he can also be cruel because he enjoys being cleverer than everybody else. The programme sometimes encourages us to forgive him because the patient survives and the diagnosis turns out to be right. I’m less comfortable with that argument than I might once have been. Being exceptionally good at something doesn’t entitle you to behave appallingly, and that tension is central to why the character still interests me.
The People Who Had to Work with Him
A character like House needs people willing to challenge him. Otherwise, eight seasons of listening to one man explain why everyone else is an idiot would become exhausting. Fortunately, the supporting cast provided rather more than an audience for Laurie’s performance. Their arguments accumulated history, and that history gradually became the most important part of the show.
Dr James Wilson (Robert Sean Leonard) was House’s closest friend and in many ways the emotional centre of the series. An oncologist with a gentler manner, Wilson spent an extraordinary amount of time understanding, defending or repairing the damage caused by House. The friendship was often funnier than the medical cases: House stole his food, occupied his office and interfered with his private life simply to get a reaction. Wilson tolerated rather more than most reasonable people would, although his own guilt, insecurity and troubles with intimacy meant he wasn’t entirely innocent either.
Dr Lisa Cuddy (Lisa Edelstein) had the unenviable responsibility of running a hospital while employing a man who treated regulations as something to argue about. As Dean of Medicine, she was one of the few people capable of standing up to him. Their relationship developed from sharp exchanges into an extended romantic complication, but I sometimes wished the writers had allowed her to win more arguments. Cuddy was far too intelligent and capable to exist merely as somebody trying to keep House out of trouble.
Dr Eric Foreman (Omar Epps) was probably the original team member most capable of challenging House intellectually. Disciplined and ambitious, he resisted the notion that brilliance justified bad behaviour, even while gradually becoming more like his mentor. That possibility gave Foreman a useful internal conflict. He understood why House’s methods worked and recognised the damage they could do.
Dr Allison Cameron (Jennifer Morrison) offered a different perspective. She was empathetic, idealistic and often uncomfortable with the way the team prioritised the puzzle over the person. Sometimes the writing made her morality feel like a convenient obstacle, but the department needed somebody willing to remind the others that patients were not simply collections of symptoms. Dr Robert Chase (Jesse Spencer) initially seemed more adaptable and opportunistic, but developed into one of the series’ most complicated figures.
Chase’s decision to kill the dictator Dibala in the sixth-season episode The Tyrant forces a moral issue that cannot be settled by diagnosing the right disease. His later development gives his eventual professional future a credibility that would have been missing in the early years. Stacy Warner (Sela Ward), meanwhile, knew House before his leg injury and revealed a more personal history that the hospital staff could only guess at.
For me, the programme was strongest whenever House, Wilson and Cuddy were all involved. Their relationships had accumulated enough history that an ordinary disagreement could carry more weight than the medical case surrounding it. When the show eventually changed that arrangement, it lost something that even a talented new diagnostic team could not quite replace.
Forty Applicants and One Terrible Recruitment Process
By the fourth season, the original diagnostic team had effectively disintegrated. Rather than quietly hire replacements, House turned recruitment into a competition involving forty applicants, each initially assigned a number. It was ridiculous, theatrical and entirely consistent with his personality. It was also a clever way to refresh a formula that had begun to look rather familiar.
Dr Remy Hadley, better known as Thirteen (Olivia Wilde), arrived guarded and unwilling to disclose much about herself. Her eventual diagnosis of Huntington’s disease gave her story a painfully personal relationship with medicine. Unlike House, whose chronic pain was part of daily life, Thirteen had to confront the knowledge of an illness that would progressively change her future.
Dr Chris Taub (Peter Jacobson) was an experienced former plastic surgeon whose private life was often an exercise in poor judgement. He was intelligent enough to understand his own failings and not consistently disciplined enough to correct them. Dr Lawrence Kutner (Kal Penn) contributed enthusiasm, curiosity and a readiness to consider improbable possibilities, qualities that made his eventual departure particularly unsettling.
Kutner dies by suicide in the fifth season, leaving the team searching desperately for an explanation. The real-world departure followed Penn’s move to a role in the Obama administration, but the writers resisted giving the character’s death a tidy fictional answer. House cannot accept the absence of one and approaches the loss as another mystery to be solved, only this time there is no reassuring revelation waiting at the end.
Dr Amber Volakis (Anne Dudek) deserves particular mention, although she never secures a permanent position on the team. Competitive, abrasive and unapologetically ambitious, Amber becomes involved with Wilson, creating a fresh source of friction between the friends. Her eventual importance to the series is far greater than her original role as a prospective employee would suggest.
Later additions included Martha Masters (Amber Tamblyn), whose insistence on honesty made her an entertaining opponent for House’s methods, and Jessica Adams (Odette Annable) and Chi Park (Charlyne Yi) in the final season. Park’s awkward frankness was enjoyable, although neither she nor Adams had quite enough time to build the accumulated history of the earlier team members. Even so, the rotating cast kept the series from settling into complete predictability.
The Hospital as a Puzzle Box
The production design of House was relatively restrained, which suited the material. Princeton-Plainsboro was all glass partitions, polished surfaces, muted colours and corridors that seemed designed for spontaneous arguments. House’s office was the exception, filled with instruments, books, toys, anatomical references and the occasional object that looked as though someone had forgotten to take it home.
I always liked the way Laurie occupied that office. House might be playing with a ball, examining an object, listening to music or staring into the middle distance while his colleagues tried to work out what he was thinking. The props mattered because they gave the actor things to do during the dialogue. House was never particularly convincing as somebody who could sit politely behind a desk and pay attention to a meeting.
The hospital exterior was television illusion: Princeton University’s Frist Campus Center supplied the establishing shots, the pilot was filmed in Vancouver and subsequent production was based mainly in Los Angeles. There were also the programme’s occasional computer-assisted journeys inside organs and blood vessels. These could be faintly unpleasant over dinner, but they gave the medical puzzles a physical dimension beyond people discussing test results.
One particularly interesting technical detail arrived with the sixth-season finale, Help Me, which was filmed on Canon EOS 5D Mark II digital SLR cameras. Director Greg Yaitanes and cinematographer Gale Tattersall used their compact size and shallow depth of field during a story about a building collapse. That appeals to the designer and photographer in me: the episode belongs to a moment when comparatively small still cameras were beginning to change assumptions about what professional television could be shot on. The confined spaces and intimate photography also work dramatically, forcing House into a situation that cannot be solved by standing at a whiteboard.
The Episodes That Broke Their Own Rules
With 177 episodes, House inevitably developed a pattern. Someone became mysteriously ill, the team reached several wrong conclusions, House had a revelation and the answer appeared in the final minutes. The stronger episodes were often those willing to interrupt that arrangement, either by changing the point of view or by making the person in danger somebody the audience already knew.
The first season’s Three Stories remains one of the best examples. Required to deliver a lecture, House recounts three cases involving leg pain. As the stories unfold, we realise that one patient is House himself, and learn about the infarction, its treatment and the decision made by Stacy while he was unconscious. It changes our understanding of the character without asking us to approve of him. David Shore deservedly won an Emmy for the writing.
The second-season two-parter Euphoria makes the mystery personal when Foreman contracts a mysterious illness. The team’s familiar professional distance collapses once one of its members is the patient. One Day, One Room, from season three, presents a very different difficulty: House meets a woman recovering from sexual assault, and finds himself facing circumstances that medicine alone cannot resolve.
The fourth-season finale, House’s Head and Wilson’s Heart, is probably the show’s most ambitious two-part story. After a bus accident, House suffers a head injury and cannot reconstruct his fragmented memories. He knows somebody from the accident may be dying, but cannot remember who. The episode approaches the problem like a psychological thriller, using hallucinations and reconstructed scenes to reveal what happened.
The person House is trying to identify turns out to be Amber, who was travelling with him. In Wilson’s Heart, damage to her kidneys means that she cannot clear amantadine from her body. Unlike the usual weekly case, the illness cannot be reversed through a miraculous last-minute discovery. Despite everyone’s efforts, Amber dies, and the effects on Wilson and House continue well beyond the episode.
Robert Sean Leonard and Anne Dudek are particularly good in these scenes, which are devastating largely because the usual formula stops working. Greg Yaitanes won an Emmy for directing House’s Head, and it is easy to understand why: the storytelling and images are unusually adventurous for a network procedural of the period. The programme had spent years making House appear unbeatable, then placed him in a situation where intelligence was not going to be enough.
Other worthwhile departures included Locked In, told partly from the perspective of a patient unable to speak, and Frozen, in which the team attempts a remote diagnosis of a patient in Antarctica. The scientific explanations can become improbable, but their structural ingenuity is what makes these episodes memorable. They understand that changing who holds the information can be as interesting as changing what the illness ultimately turns out to be.
When the Doctor Became the Patient
The fifth season pushes House into increasingly uncertain psychological territory. Following Kutner’s death, he begins experiencing hallucinations involving Amber. What initially seems to be another bizarre extension of his personality becomes evidence that he is seriously unwell. In Both Sides Now, he realises that his apparent detoxification and romantic encounter with Cuddy never happened. He has constructed the reassuring experience inside his own mind.
It’s a disturbing reversal of the normal arrangement. House, the man who has spent years identifying deception in everyone else, cannot rely on his own perception. The sixth-season premiere Broken follows him into psychiatric treatment at Mayfield, where Dr Darryl Nolan refuses to accept his usual evasions and manipulations. Andre Braugher’s restrained performance works particularly well against Laurie’s increasingly exposed House.
I appreciated the change of setting. House no longer controls the diagnostic department, cannot intimidate his doctors into backing down and has to confront the possibility that recovery involves rather more than winning an argument. There are lighter moments, including his friendship with fellow patient Alvie, played by Lin-Manuel Miranda, but the storyline resists pretending that rehabilitation is a conversion experience. House improves without becoming an entirely different person.
His chronic pain remains an uncomfortable physical presence as the series continues. After Hours, for example, has House attempt a makeshift operation on himself, a sequence that is difficult to watch even though the programme has always enjoyed pushing his decisions towards the edge of reason. By the eighth season, after the incident at Cuddy’s home, he has also experienced prison and the humiliating restrictions that come with being placed under Foreman’s authority.
The Trouble with Being Right All the Time
For all its strengths, House wasn’t immune to the usual problems of a long-running network drama. The cases became increasingly elaborate, partly because the writers had already used so many straightforward possibilities. Patients developed extraordinary combinations of symptoms, treatments caused dramatic complications and the right answer often arrived after a series of interventions that would raise some serious questions in an actual hospital.
The production drew on real medical knowledge and advisers, but its hospital existed to accommodate a particular sort of mystery. There is also the problem of House’s behaviour. The series sometimes treated repeated violations of professional boundaries as charming eccentricities. Patient privacy could be ignored, colleagues manipulated and offensive remarks presented as evidence of his refusal to tolerate social pretence. Some of the humour still works because Laurie delivers it so well; other parts have aged less comfortably.
The writing wasn’t always equally generous towards its female characters. Cameron’s conscience could become a convenient obstacle, while Cuddy was sometimes reduced to managing House rather than exercising the professional authority her position should have given her. Those shortcomings become particularly troublesome as the series approaches the end of its seventh season, when House and Cuddy’s relationship collapses.
In Moving On, House deliberately drives his car into Cuddy’s home. I find this a difficult development to reconcile with the earlier character. House has always been capable of cruelty and self-destruction, but there is a difference between sabotaging your own life and committing an act that could injure somebody else. The room being empty at the moment of impact does not make it a prank. Lisa Edelstein’s subsequent departure also means Cuddy’s story never receives the fuller resolution it needed, leaving a noticeable gap in the final season.
The Music Was Never Just Background
Another thing House understood was how to use music without turning every emotional moment into a sentimental speech. The most familiar opening theme is Massive Attack’s Teardrop, whose heartbeat-like rhythm suited the show’s medical imagery remarkably well. Not everybody heard the same opening, though. International licensing arrangements led to alternative themes in different territories and releases, a small reminder of how fragmented television distribution could be in the 2000s.
Licensed songs often appeared at important moments, while the incidental score knew when to leave room for silence. Hugh Laurie’s own musical ability added another layer to the character. Seeing House at a piano or holding a guitar reveals a capacity for concentration and expression that ordinary conversation seldom brings out. He can communicate beautifully through music while being nearly impossible to talk to.
The programme also arrived during a particularly interesting period for American television, when the traditional self-contained weekly episode increasingly shared space with longer character stories. Lost debuted in 2004, Grey’s Anatomy in 2005, and viewers grew accustomed to dramas whose consequences did not reset neatly each week. House sat between the older and newer approaches. You could watch a single medical case without knowing everything that had happened before, but the relationships carried considerable history.
Everybody Dies, but Not Quite the Way You Expect
The eighth and final season begins with House in prison following the incident at Cuddy’s home. He eventually returns to Princeton-Plainsboro, now working under Foreman’s authority, but the department has changed and the arrangement never feels entirely restored. Then Wilson receives a terminal cancer diagnosis, and the programme finds a predicament that House cannot solve with a cleverly chosen test.
Wilson’s illness isn’t a setup for another last-minute cure. He faces the possibility of having only a few months left to live, and House has to confront something he cannot negotiate, manipulate or diagnose away. The series finale, Everybody Dies, takes that problem towards a characteristically theatrical solution.
Facing a return to prison, House apparently dies in a fire inside an abandoned building. The other characters attend his funeral, where Wilson’s tribute becomes increasingly angry and bitter. Then a message interrupts the proceedings, revealing that House has survived. He escaped the building and exchanged dental records with a dead patient, allowing the world to believe he perished in the fire.
The deception means abandoning his medical career, forfeiting his previous identity and effectively disappearing from the world he has spent eight seasons antagonising. It also means he can spend Wilson’s remaining months with him. The mechanics of the plan require considerable suspension of disbelief, but its purpose makes an unexpected kind of emotional sense. For once, House decides another person matters more than being right.
We see the other characters moving forward. Chase takes charge of the diagnostic department, Foreman continues as Dean of Medicine, Cameron has established another life and Taub makes his complicated attempt at family responsibility. Warren Zevon’s Keep Me in Your Heart accompanies the closing montage, before the last motorcycle journey plays out to Louis Prima’s Enjoy Yourself (It’s Later Than You Think).
House and Wilson ride away without any assurance that Wilson will survive, and without much indication of what House intends to do afterwards. It isn’t exactly a happy ending, but I think it suits the series. The man who spent years proving everybody else mistaken finally makes a choice that isn’t entirely about himself, even if he has to fake his own death to manage it.
What House Left Behind
Looking back, I’m struck by how much of the programme’s appeal had surprisingly little to do with medicine. The mysteries were clever, the production accomplished and the supporting cast strong enough to keep the formula interesting for a long time. Laurie gave the series a central performance that could be amusing, infuriating, cruel and unexpectedly vulnerable, sometimes within the same scene.
But the question running through those eight seasons was whether being exceptionally good at something made a person exceptional in any other meaningful sense. House could identify diseases everybody else missed and recognise motives other people tried to conceal. He was also frequently incapable of admitting that his own behaviour was destroying something worth preserving. The series sometimes seemed too eager to celebrate his intelligence, and his colleagues were asked to tolerate more than was remotely reasonable.
Even with those weaknesses, House remains one of the more distinctive medical dramas I’ve come across. It made diagnosis entertaining without pretending that knowledge could solve everything, and it understood that intelligence and wisdom are entirely different qualities. Somebody could be right about an illness while being profoundly wrong about the people around him. In the end, the person who had spent eight seasons finding answers discovered something he couldn’t fix and chose, at last, to be there for his friend. For Gregory House, that was probably about as much personal growth as anybody could reasonably expect.
Editorial image credits: House television production and publicity stills. Copyright remains with the respective photographers, studios and distributors.
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