House – Episode 1: “Pilot”

I caught the new medical show House on Fox Tuesday night (it is scheduled to be rebroadcast Friday night). I enjoyed it and the show definitely has potential.

Hugh Laurie does an excellent job portraying the eponymous Dr. Gregory House. Dr. House is a wounded (both physically and mentally) character who is considered one of the most brilliant physicians in the nation. The trouble is, he hates to deal with patients. His ethics and morals are questionable. He is a complex and interesting character. The rest of the cast is more forgettable. Omar Epps and Jennifer Morrison show some promise as two of the young doctors; the third young doctor, played by Jesse Spencer, doesn’t show much of a personality yet. Robert Sean Leonard simply fades into the background whenever he’s in a scene.

The plot was essentially a medical mystery. Why does this pretty young kindergarten teacher have all these horrible symptoms? What condition does she have, and how do we cure it?

The answer was clever and not too unbelievable. I did have problems with the way the supposedly brilliant Dr. House arrived at his conclusions. There seemed to be no logic behind his deductions, he just seized on some minuscule fact and used it to concoct some untenable theory. That he turned out to be right in the end seemed more luck then skill.

Still, the series was very watchable and I’ll make sure to watch next week’s show.

Some minor nit-picks (and very minor spoilers):

  • Are there no radiologists or radiology techs at the hospital? How come the young guns have to run all their own tests?
  • Wasn’t it convenient that the teacher got a severe allergic reaction to the gadolinium and couldn’t receive the diagnostic MRI — even had an emergency tracheostomy — yet managed to recover from this anaphylactic shock in a phenomenally fast time? And even if she couldn’t get the MRI done, what about a CT scan?
  • No oncologist I know would give radiation therapy without knowing first what kind of cancer it is, or at least exactly where it is.

42 Responses to “ House – Episode 1: “Pilot” ”

  1. Yes, HOUSE reran last night. I excitedly set my TiVo up for it in advance, but it didn’t record because the schedule change never took hold, so the TiVo listings never had the updated schedule for the rerun at 8. Crap.

    I’ll either BitTorrent the episode now, or wait for the DVD set next year. I have enough to watch for now.

  2. “That he turned out to be right in the end seemed more luck then [sic] skill.”

    Someone skipped English 101 in college…

  3. Someone needs to learn how to spell “grammar” before he or she critiques that of others…

  4. do you not get it??

  5. I would like to ask, who are you? Who is writing these articles? Some M.D. or student? Please reply . . .

    thx.

  6. House does say that there was nothing on the CAT scan. Hence the CT was performed off-screen.

  7. I absolutely love this show.

    However, when you see House’s eyes, his pupils are never pinch-small or even constricted. As I’m also getting medicated with Tilidine (also an opiate), and opiates in general constrict the pupils. But this is just a nit-pick and nothing really bothering to me ;)

  8. Your criticism that they could have performed a CT scan if they couldn’t do an MRI is questionable. They said they did an CT scan. I think they just did it of the skull so it did not show up the parasite as clearly as the one they ran later of her thigh. This happens in a later scene and is remembered by first by Jesse Spencer.

    Also, your critique that House doesn’t seem to reach his conclusions without any basis for the deduction seems to miss a dimension I have noticed in a few brilliant people I’ve met. Very often an insight is gotten to as a quantum leap when they are doing something seemingly completely unrelated. I have figured out riddles before when I take my mind off the subject entirely. House does this many times in the upcoming series and it part of the brilliance of his character. Other characters who have less ability than he, demand that he produce the exact steps that they need to understand how he reached a his conclusion. House simply jumps straight to the conclusion.
    As for there being no radiologists or lab techs available for the grunt work, the doctors that House has hand-picked are assigned exclusively to him as his assistants. Since the medical problems that he is solving are very unique, he uses them to make sure the grunt work is done correctly. Otherwise, he has to work with potentially bad data.

  9. Dr. House uncanny ability to arouse an answer that seems without ebb can be practiced in
    any occupation. Simply engage others without hesitation in an open demeanor and discuss
    any particular topic. What is important is the underlying context of the engagement. One
    or all participants will bring about valuable information to the discussion. Some may
    say that such avenue is an uncivilized unconventional approach. The key is to to connect a
    link and let our cerebral cortex the unadulterated freedom to exercise its potential
    rights. Just a thought!

  10. what disease does she have

  11. nazmul, the patient had neurocysticercosis — tapeworm in the brain.

  12. I’ve just discovered this show (have seen only this episode so far), and despite all the suspense and interesting characters, the whole story about cysticercosis is far-fetched. Cysticercosis can be acquired *only* when eggs of a tapeworm living in the intestine get activated by gastric juice and get disseminated all over the body with the blood. It means that cysticercosis is only a complication of a tapeworm invasion. That said, the easiest and straightforward way to confirm cysticercosis is to look for tapeworm eggs in the feces.

  13. Only 10% of patients have the tapeworm during the NCC neurocysticercosis presentation, so if you look the feces, you may not find anything. Although, 25% of the NCC cases can be linked with a past tapeworm infection. The eggs don’t have to necessarily have to go through the estomach, it can happen in case of retroperistaltis, but the auto-infection is more common. i just didn’t understand why they haven’t tested for the immune response in the patient, with serum, LP or even saliva.

    In cases of doubt, just check this article… I hope you know Portuguese… http://www.portaldapesquisa.com.br/ATHENEU180/85-7379-585-9/17.pdf

  14. “However, when you see House’s eyes, his pupils are never pinch-small or even constricted.”

    Oh, well! I THOUGHT Hugh Laurie was really good in this role, but knowing this… pfft! What a hack! I’ve just lost all respect for him.

    ;)

  15. ‘However, when you see House’s eyes, his pupils are never pinch-small or even constricted.’

    Possibly mere speculation but I imagine this demand for medical perfection is slightly beyond the contractual agreement which Hugh Laurie has.

  16. Thiago – I am actually interested to see that article but it is not accessible to the public. Can you put it somewhere visible – and maybe a pointer to a portuguese medical dictionary online, my everyday portuguese may struggle with the medical terms.

  17. I agree with several others—mostly in later episodes’ pages—about the enjoyment and usefulness of participating in a forum where the medical side of the episodes is explored. Good to have you, Scott. :-) Personally, I have no medical background, but I do have a rudimentary knowledge of biology, which helps me roughly understand what is going on medically. In any case, I mostly watch the series for the drama, the humour, and House’s sarcastic genius and detective abilities, so I’ll mostly be commenting on these. I have been watching the episodes mostly randomly (courtesy of our local channel), with many second-season ones missing, but am now starting from the beginning and in the correct order.

    (Forgive the rant, but this is my first post, so an introduction seemed fitting. Besides, someone might be interested in viewers’ statistics, hehe.)

    I agree with John and Randy; Dr House is built on familiar Holmesian patterns, impressing people by subtracting the intermediate links of a reasonable chain of deduction. Speed and the ability to notice or take into consideration elements missed by others are also significant assets. I suggest reading the Wikipedia articles on the series and the character, which I’d say are rather good, and give various parallels between Dr Gregory House and Mr Sherlock Holmes, as well as an insight to how this show started off.

  18. Relevant news

    From June 25, 2008, LA Times article, “Exotic illnesses afflict American poor”
    “In the Los Angeles area, a pork tapeworm infection called cysticercosis which spreads in crowded, unsanitary conditions, accounts for 10% of seizures resulting in emergency room visits, according to the report. Worm cysts in the brain cause the seizures and can lead to permanent epilepsy.”

  19. Sometimes I think that house doesn’t really know what’s he’s doing. That’s why he needs the team because he can’t figure things out for himself. I don’t know if anyone else has noticed this, but I have.

  20. I love the show the show. M.D. to.be. may have a little something… but watch episode 1 of season 4. I do have to say I believe his ideas are so abstract that he needs a great medical team to elimate the ideas a team of pros can only elimate right away. Also on comment to ‘grammers’ little thingy. I got an A in english 101 when i took it, and my online grammar is the worst of anyone I know… LOL (do you know what that means?)

  21. @ Anon February 18th, 2007 at 11:55 pm
    His mistake does not disprove his argument.
    Fallacy ad hominem.

    The ability to correctly spell grammar is not a requirement to critique others.

    Example 1, Premise 1, I am right.
    Conclusion 1, You are wrong.

    Example 1 is possible.

    Example 2, Premise 1, I am wrong.
    Conclusion 1, You are right, being able to spell grammar is required to disprove someone.
    Conclusion 2, I correctly spell grammar and disprove your argument.
    Conclusion 3, I am right.

    Example 2 is illogical. The conclusion disproves the premise.

    Example 3, Premise 1, We are wrong.
    Conclusion 1, The ability to correctly spell grammar is neccessary in order to prove any point invalid.
    Conclusion 2, The ability to correctly spell grammar is not neccessary in order to prove any point invailid.

    Example 3 is illogical. Both conclusions contradict each other.

    Save an alternative example, I am right.

  22. excellent!!! :))

  23. what about the ability to spell “necessary”?

  24. first one looks so funny now…

  25. Yes, the first episodes where dark and gray.

  26. Example 3, Premise 1, We are wrong.
    Conclusion 1, The ability to correctly spell grammar is neccessary in order to prove any point invalid.
    Conclusion 2, The ability to correctly spell grammar is not neccessary in order to prove any point invailid

    Necessary
    invailid? …. invalid.
    This has turned into a linguistic pissin’ match.

  27. //I got an A in english 101 when i took it, and my online grammar is the worst of anyone I know… LOL (do you know what that means?)//

    Yes, it means you are socially retarded, if you A) laugh out loud at such a lame joke B) laugh out loud at your own joke C) have to insert exaggerated claims of humor in order to get your point across.

    Good luck with that.

  28. > This has turned into a linguistic pissin’ match.

    they aren’t linguists. they are naught but nerds

  29. Ha! Speaking as a hospital nurse, I’d like to work in that place knowing that the doctors do everything, like collect specimens and put in their own IVs.

  30. Thanks for this TV serials, its help me to face Medical School in my country. Who is dr. House exactly?

  31. @Bayu-Who is Dr. House exactly?
    Either a completely fictional character, who’s medical career is nothing like what you’ll face after medical school, or the scruffy looking guy with the limp.

  32. Hey, I really like Dr. House actually.. But I have some questions.
    Do u guys really use so many technologies over and over again on just one case in America? And what is it with HMO that people are so reluctant of taking??

    Thx:)

  33. Dee:

    This show is about cases that are extremely difficult to diagnose. It’s extremely rare for us to “use so many technologies over and over again on just one case”.

    I have no idea what an HMO is, but Wikipedia is your friend.

  34. Is the x-ray image of the tapeworm reasonable? If the density of a tapeworm is the same as the cerebrospinal fluid, shouldn’t the thigh muscles have a higher density? Then the warm should show up as a darker spot instead of a brighter one, right?

  35. the basic concept of this episode is wrong. in neurocysticercosis when u give only albendazole it may cause death of the worms releasing toxic products thus aggravating neurological symptoms which get reversed by treating with steroids. it is shown in this episode as exactly opposite. that is steroids aggravating symptoms relieved by albendazole which is wrong.

    answer to michael, it is true that density of the cyst wall of the worm is same as that of CSF, hence ventricular neurocysticercosis alone cannot be detected by CT. but is the same cyst is in brain parenchyma then it can be detected by CT. in the thigh muscles usually the cyst wall become calcified hence would be of higher density, that is compared to that of the bone.

  36. House has his team run all of the tests, lab work, and other scans excetera, because he doesnt trust labbies, techies, and nurses to deal with anything.

  37. very interesting how often the basic concept of an episode is wrong.. coz i was sure the serial was based on true stories..

    (i have no relation to medicine)

  38. [...] House – Episode 1: “Pilot”, 19.11.2004, Polite Dissent [...]

  39. The best of the best serial.

  40. Years after I started watching house I finally get the opportunity to see this episode. Intresting choice of color filtering (desaturating all but yellow/orange in many shots) – it’s actually kind of cool to see it now grossly out of order because it has a “back-in-time” look to it.

  41. HMO is an health provider. Is like a private health insurance.

  42. Kevin – this is actually one of my favorite episodes because of this very cinematic look.
    Bryan Singer directed this episode, and IMO, it really shows. The whole episode is desaturated, in some scenes in the hospital the color has been completely removed from everything except the actors, who have a sort of glow – even the clothing is black/white. There are more crane shots than I usually see in television…
    Obviously I could go on and on.
    I LOVE the look of this episode. I think it was a very, very bold choice by Singer, and it’s a masterpiece of post-production.
    I’m glad they didn’t stick with this look for the entire series, as it’s quite distracting, but oh, it is LOVELY.

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