House calls

Jenny Rattray at the UMO recommended House, currently showing on Channel 5 at 22.00 on Thursdays, and I finally got round to watching a couple of episodes. It completely bucks the trend of most modern hospital dramas towards realism and goes for idealism instead. The show's main draw is 'Dr House', played intriguingly against type by Hugh Laurie, with a gravelly American accent, a permanent 6 o'clock shadow, a limp and an attitude problem. House has no regard for ethics or hospital procedures and he frequently places his patients' lives at risk, but he always works out the correct diagnosis in the end. This (at least in the two most recent episodes) was down to Sherlock Holme's type deductional reasoning based on bad reactions to experimental medications and taking a chance on the less obvious diagnosis. House has three sidekicks. Curiously, none of them seems to have a caseload of more than the single patient featured in each episode. It's supposed to be set in a teaching hospital, yet the environment looks more like a law firm that's been featured in an episode of 'House Doctor' (sorreee!) and the patients seem all to have private rooms. There isn't a ward (or a nurse for that matter) in sight. House has a spacious office that looks like a board room. Are you sure this isn't science fiction?

Okay, so reality doesn't intrude on the plot circumstances, but what really interests me is why the show remains so watchable when the vast majority of viewers (with no medical education, myself included) have no conceivable chance of 'solving the mystery' ahead of House. The fun of reading an Agatha Christie novel or others in the detective genre (of which House is a medical visual example) is that you get to have a shot at working out whodunnit. With House you have no chance of second guessing the obscure diagnosis. Dr House is blatantly far more interested in the diagnostic puzzle than in the patient, and is thus the antithesis of your caring, communicating doctor. Yet, someone that determined to provide a definitive answer to a complicated set of symptoms and circumstances is hugely compelling as a doctor. Uncertaintly is a deep-seated cause of anxiety and I think the satisfactory resolution aspect is what contributes, I think, to making House compelling viewing. It would be interesting to hear comments on the show from a medical point of view.

As a quick aside, starting tonight on BBC2 at 19.35 (repeated on BBC4 at midnight on Monday) is The Guinea Pig Club, a drinking club for disfigured WW2 pilots. It's based on a book, The Reconstructions of Warriors, by Imperial College's Humanities Research Fellow, Emily Mayhew, who has a special interest in the history of plastic surgery. She won an award for her work on the series.