House, MD
Monday, May 18 2009
I mentioned that many doctors think Scrubs is the most realistic medical show on television. According to ER Drama, the least realistic – no surprise – is House, MD:
Watching House, MD though, things have been taken to an even higher level of unrealism… So why does this matter? It matters because there are a lot of people out there who have a big problem between fiction and reality.
The author, Dr. Heal, is an ER Doc. I appreciate his frustration, which I’ve heard from other doctors, too. It’s the same frustration attorneys have for most legal dramas, or that cops have at cop shows – for that matter, somewhere right now a meerkat blogger is complaining about the half-truths and exaggerations of Meerkat Manor. So, yes, House, MD is unrealistic. But let me explain why this doesn’t matter: if you’re a patient, it’s the best show on television.
To appreciate that, you need to understand two things that are not obvious: first, it’s not a medical show. It’s a mystery show. The series is quite deliberately modeled on Sherlock Holmes; House = Holmes, Wilson = Watson. Get it? And it’s a very good mystery show – taut plotting, crisp dialogue, and sharply-drawn characters, with some of the best acting out there. It just happens to be a mystery show set in a hospital, the way Scrubs is a sitcom set in a hospital. Neither House nor Scrubs are “medical shows”, in the sense of belonging to that particular genre.
Second: to the extent that House borrows from the medical genre, it does so as wicked satire. Even when the genre was fresh – aeons ago – medical shows never showed doctors and patients with any modicum of realism. That’s not to say fiction owes any fealty to reality: a work of art is no less true for being entirely unreal. But to complain that House, MD is an “even higher level of unrealism” misses the point: that “higher level” is it genius, its edge, its truth. That higher level shows the plain stupidity of lower level shows – current, prior, and forever.
Take, for example, the representation of doctors in medical dramas. After decades of watching TV doctors’ failings unfold in prime time, audiences are fully prepared to lionize any person claiming an MD – even an arrogant junkie misanthrope like Gregory House. No real patients wants Dr. House to be their doctor – except for the fact that he solves every case, which is true of almost any TV doctor and exactly zero real doctors. This is a trope deeply ingrained in the medical show genre; it’s not original to House, nor has the medical profession done much to disabuse audiences of the notion. You can still find plenty of doctors who wear their degrees like a combination crown/halo; every patient knows at least one. (For the record, Dr. Heal does not seem to be one of these.) I’m sure those doctors loved the image of physician as all-knowing, all-healing superman – and certainly all physicians benefit from it. Of course they don’t appreciate seeing the myth perforated; but for patients, this is an absolutely necessary step. We need to learn that our doctors inevitably possess some degree of human weakness, even if we don’t see a cane.
The best, most realistic part of House – for me, as a patient – is its sense of humor. About 99 times out of 100, when someone not sick tells you humor will help you get through your illness, what they mean is that you shouldn’t think too hard about your bold new world of suck. You are instead supposed to divert yourself with trifles: thus was born the “Hang In There” kitty. What they don’t mean – what scares and confuses them - is that you should actually laugh at illness, pain, and death itself. That makes kitty cry. Yet I have found that my best, my only defense against the horror is to laugh at it. If I allowed myself to take my illness too seriously, it would overwhelm me; fear would be my only reality, death my only hope. If I want to take my life seriously, I have to be able to laugh at death.
Medical shows can’t laugh at illness and death, because that would deprive them of the tension necessary to hold their audience for 47 minutes at a time. They have to take it all so seriously, so earnestly – and so medical shows are humorless and tedious when it comes to illness and death. But nor can they be realistic in their seriousness: if these shows were honest about the reality of medicine, without any humor, they would be so deeply depressing and disturbing as to be unbearable. They exist instead in an over-exposed snapshot of reality – where doctors win more than lose, patients are always inspiring, and every disease is an emergency. As such, these shows don’t reflect my experience, don’t appeal to my sensibility, and don’t offer anything I recognize as truth about the human condition.
But House, MD starts from a different premise – already so unrealistic, so hyperbolic and excessive, that it has no obligation to take itself seriously as a medical show. The dilemma in House is not life or death – it’s knowledge. This, to me, is a far more compelling problem than death. The truth is, we’re all going to die: we just don’t know how or when, yet. In the meantime, House, MD offers a way past the horror: because the show doesn’t have to take life and death so seriously, it gets to have a lot more fun. It gets to be funny – and therefore true – in ways a million Grey’s Anatomy script-writers typing on a million typewriters could never be. Hugh Laurie is no less than a messenger from heaven, telling us it’s okay to laugh.
Ultimately, House, MD is not a show about medicine; if you want that, there are lots of mostly accurate, perfectly dull medical reality shows on Discovery. I don’t think anyone – not any patient – should watch House, MD thinking, “this is how medicine should work.” That’s not the point of the show, nor the point of fiction more generally. Yes, there are some dumb people who don’t get it – but art, even television, isn’t obliged to the dumbest people in the audience. For the rest of us, House is one the best things on the air right now; not an entry to the reality of medicine, but an escape.
(ER Drama link via Kevin, MD)
I love you.
u got it! tv shows are, ultimately, just entertainment. so let us be entertained without worrying about people saying it’s “not realistic enough”!