Paging Crichton, 'House' Hurting

Nearly buried in the non-stop media coverage of Election Day was a much sadder story, especially for those who, like me, grew up idolizing Velociraptors and wanting to visit Jurassic Park. Michael Crichton ’64 died of cancer at the age of 66. As fate would also have it, “ER”—the primetime TV medical drama Crichton created, wrote, and produced—is in the midst of its 15th and final season, ending after February sweeps in 2009. As can already be seen in other medical dramas like “House,” Crichton’s absence in this genre will be strongly felt.

Upon graduation from Harvard, Crichton received Summa Cum Laude honors and became a member of Phi Beta Kappa before earning his M.D. from Harvard Medical School in 1969. He began publishing books under various pseudonyms shortly after receiving his undergraduate degree, and one of his first successes was a 1968 novel called “A Case of Need” about an abortionist. From that point on, many of his works focused on warning of the dangers posed by emerging technologies, netting him a label as a “cautionary tale” novelist.

He is probably best known for his books “Jurassic Park,” “The Lost World,” “Congo,” “Sphere,” and the movies they became, though I would argue that one of his most profound accomplishments was “ER.”

Using his background as a trained physician, Crichton not only created and wrote a convincing television series that revealed the chaos of a typical urban emergency room, but he also did so with a previously unparalleled level of accuracy. Though past cast members George Clooney and Noah Wyle didn’t know a laryngoscope from pericardiocentesis, trained doctors and nurses were brought in to consult during production in order to make the show as realistic as possible.

Threaded together with overarching plots, these true-to-life details made for a ratings hit. For its first four seasons, the Emmy-winning show maintained an average of around 30 million viewers per season.

All of this began to change in 2004, though, as the show’s viewer ranking slipped out of the top 15 and its average viewership was halved. This may be the result of NBC’s general slide, the rise of internet TV, or simply just a drop in quality. But these may merely be secondary factors, since FOX’s “House” premiered in 2004.

For those who aren’t familiar with the show, it follows Dr. Gregory House (played by Hugh Laurie) as he solves ridiculous, though basically factual, medical mysteries at Princeton-Plainsboro Teaching Hospital. Although presumably entertaining for those interested in dumbed-down medical horror stories, “House” and the expectations it builds with its audience present a number of issues.

First and foremost, its important to address who is making the show. Unlike “ER,” “House” was created by a layman, David Shore, and although the show is purportedly inspired by medical columns from The New York Times and The New Yorker, it isn’t exactly clear on what distant reality the show is based.

Unlike in “ER,” where innumerable patients must be treated at a moment’s notice, House is able to spend days diagnosing one patient and doing several trillion dollars worth of tests. In real life, hundreds of people would have died, waiting in triage, while House made cranky jokes about a man whose skin had miraculously turned all the colors of the rainbow. You can also bet that the man’s insurance company wouldn’t cover even a quarter of the litany of tests for which House calls. The creators have tried to hide behind the guise of a “teaching hospital” in order to create the sense that doctors would have infinite time with patients, but this too strikes me as a relatively weak attempt to create realism.

Even though House holds a cane and is addicted to Vicodin, he still isn’t as old or insane as he would need to be to have completed so many specialty courses in medical school. A ripe, obnoxiously saucy bachelor at middle age, House is somehow a cardiologist, epidemiologist, radiologist, neurologist, orthopedic surgeon, dermatologist, endocrinologist, pulmonologist, gynecologist, and psychiatrist, in addition to being versed in a few other specialties, sprinkled in for good measure. There is no other way to put it; the show is completely unrealistic. Noah Wyle may be a pretty boy, but after years of watching television, I would much rather have him taking care of me in the I.C.U.

To put it mildly, House is a morally repugnant character who’s often guilty of sexist and racist remarks to both his colleagues and patients. At any respectable hospital, he would be facing harassment charges that would likely permanently remove him from medicine.

Critics of my opinion will point to shows like “Grey’s Anatomy” and “Scrubs,” and to them, I will simply say that the former is a chick drama with a little scalpel and the latter is all comedy with a bit of depressing death irony provided by Zach Braff. “House” knowingly advertises itself as neither of these things despite having some of both, and instead focuses on the pop medicine lightness of an everyone-gets-a-cure world.

The success of “House” and the decline of “ER” might be purely coincidental, but it may also indicate a lazy desire to ignore the realities of hospitals and embrace a misleadingly optimistic view of healthcare. Were it simply watched as entertainment, I might not have a problem with “House,” but with patient behavior always a concern, I can’t help but think that the show might build ridiculous expectations for a system that is actually broken. Regardless, I’m going to miss Michael Crichton, his books, and “ER,” and I wonder who he got a seat next to in writer’s heaven.

—Columnist Andrew F. Nunnelly can be reached at nunnelly@fas.harvard.edu.