The House M.D. Finale: Goodnight, House

Published on
May 21, 2012

house m.d., andrew holtz, reporting on health, health journalismAs I write this note, I've got plans to spend the evening seeing off an old friend. Well, he's not exactly a friend, but I've gotten to know him very well over the past several years. Actually, he;s not even a real person, but he's had a real effect on the lives of millions, with an especially strong effect on my professional life.

Dr. Gregory House makes his final original appearance as the Sherlock Holmes-inspired, addicted (or recovering), misanthropic, brilliant physician who seems to hold the entire contents of the National Library of Medicine in his head. The medical detective series "House" will be in reruns indefinitely, but after eight seasons the flow of new episodes ceases.

House entered my life in the fall of 2005, early in the show's second season, when I was approached to write a book comparing the popular series to the medical reality. "The Medical Science of House, M.D." hit bookstores as season three got underway.

My conclusion: "House" gets the medical minutiae mostly right, but the big picture reflects popular misconceptions about health care and health. Those misconceptions are also seen in outcry about "death panels" and news reports that obsess over the latest exotic medical interventions, while largely ignoring the issues in health care and the forces in our daily lives that have far more influence over our health.

The premise of "House" is that he sees only the most perplexing cases, which justifies the show's focus on circumstances so unusual that "one in a million" doesn't come close to describing their rarity. While the bizarre was routine on "House," the media, including the news media, use unusual, extreme cases as standard fare. After all, mundane cases are neither entertaining nor news. The result is that audiences are bathed in stories of rescue by heroic physicians who employ exotic tools, including experimental treatments.

Even as the popularity of "House" around the world fueled my book sales (it's available in 10 languages, if you count both European and Brazilian Portuguese translations), I heard many people dismiss concern about the effects of fictional depictions of medicine with a snort, "It's just a show!" Even Dr. House appeared to comment on such critiques. He's a fan of a soap opera set in a hospital called "Prescription: Passion." When a character called that show preposterous and unreal, House said with a shrug, "As opposed to shows that represent the world exactly the way it is . . . like . . . uh . . . can't think of any."

But go talk to researchers about the difficulty they have recruiting patients for clinical trials that would randomize some of them to receive standard care or placebo, rather than the experimental therapy. The media-amplified beliefs that more aggressive care is better than conservative care, new treatments are better than older treatments, and experimental interventions are probably better than proven ones can have real consequences.

The job of the creators and writers of "House" was to entertain. When selecting stories, the stranger, the better. Those of us who report on health and health care have a duty to inform. We dare not be dull, but when we select stories, we must not allow the sensational and unusual to dominate our reporting.

Goodnight, House. You gave us some wild rollercoaster rides. But we should always remember that while rollercoasters thrill us with simulated peril, i's the routine drive home that presents the real hazard.

Independent journalist Andrew Holtz is a former CNN Medical Correspondent and author of three books about media portrayals of medicine, "The Medical Science of House, M.D." (2006), "House, M.D. vs. Reality" (2011), and "The Real Grey's Anatomy" (2010).

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Photo credit: Kay Kim via Flickr