Much of the considerable praise attached to Fox’s House, M.D. has focused on Hugh Laurie’s incredible performance of an incredible character – the caustic genius we should love to hate, but instead love to love. None of that praise is undeserved. Laurie adds the soul and the sublime finishing touches to Dr. Gregory House.
But there is also a team of writers constructing that character, led by Emmy-winning creator David Shore, and that team deserves equal praise. Lawrence Kaplow is among them, and even he sounded almost reverential in a recent interview as he struggled for words to describe how Laurie interprets their work.
“Hugh … he is … if you were to sit on the set and watch him, it is unbelievable the performance that he delivers day in and day out. It’s just amazing,” Kaplow raved, demonstrating that proximity doesn’t destroy the magic Laurie creates onscreen, in a performance that builds on the rave-worthy scripts.
Kaplow wrote some key episodes last season, including “Detox” (with Thomas Moran), where House’s Vicodin use is explored, and season finale “Honeymoon” (with John Mankiewicz), which had House reluctantly saving the husband of the woman he loves. This season’s poignant “Autopsy,” however, is the one he’s most proud of so far. In it, House attempts to prolong the life of a nine-year-old girl with terminal cancer, after ensuring her wishes are considered.
“We see House in a different way in that episode than we’ve seen him in others. Generally he berates the patient, and yet in this one he just has a very frank conversation with her, and that conversation is incredibly emotional,” Kaplow explained. “I felt connected to the material from the very beginning.”
The Medicine: “Without that engine, it’s a really boring show.”
Though there’s a lot of research involved for the medical drama, “I do enjoy science, so that part comes easy to me,” said Kaplow, who ended up operating on sheep at a medical school during his high school summers. Abandoning his “pre-med moment,” he began his television career as an assistant on Clueless and Chicago Hope before writing for Family Law, where he met Shore, who later brought him to Hack, then House.
Kaplow described planning for the House season as a collaborative process. The writers map out the character arcs together, then the individual writers come up with patient stories for their episodes, assisted by three medical consultants.
The most crucial part is structuring the medical mystery, but “it’s deceptive,” he said, “because if you look on the web or see what people are talking about, they’re talking about character moments, which occupy not a lot of space.”
The medical mysteries, then, are the framework for character exploration. In “Detox,” for example, the tension of whether House’s Vicodin withdrawal is causing him to make uncharacteristically bad decisions is what’s most memorable about the medical aspect, not exactly what the bewildering array of wrong diagnoses are. However, it’s the trail of symptom clues and diagnostic deductions that guides the audience through the episode and through the mind of House.
“We definitely marry the character elements to the story elements, which I think is what makes the character elements resonate,” said Kaplow. “What we do is layer it in through the mystery, so we’re actually able to tell the character story through the medical mystery.”
The Character: “What he says doesn’t necessarily follow what he does.”
Because of that medical and character story integration, we often learn more about House through his reaction to the patient of the week. In “Autopsy,” selfless nine-year-old Andie is determined to scrape as much time and as many moments of joy as she can out of her short and painful life. In contrast, House whines about his hayfever, acts defiantly reckless, and alienates his only friend. He also refuses to acknowledge that Andie could be self-aware enough to understand the limitations of her life and be willing to embrace it anyway, in a theme that illuminates his own issues and inability to do the same.
“Autopsy” has House at his most obnoxiously, deliciously Housian, making his usual cutting remarks about his team (to overly emotional Cameron: “You’ll just get all warm and cuddly around the dying girl and insinuate yourself, end up in a custody battle”) but also training his equal-opportunity sarcasm on the idealization of kids with cancer (“It’s basic statistics some of them have to be whiny little fraidy cats”). He doesn’t make his “parade of the bald circus freaks” remarks in front of the patient, but he does hammer them home to oncologist Wilson, whose impression of Andie is ridiculed by his friend at the same time as he faces the heartbreaking possibility of losing her fight for life.
“We have a very good time pushing buttons, but not just for the sake of pushing buttons,” said Kaplow. “Everything that House says, every response, is justified, no matter how rude – at least in his twisted mind.”
In Andie’s case, House has humour on his side. As shocking as some of his comments are, they are put-it-on-a-T-shirt funny (“I’m not terminal, merely pathetic, and you wouldn’t believe the crap people let me get away with”). He also has an element of truth on his side. Having a terminal disease does not make someone a saint. And he has a higher purpose on his side. House questions Andie’s bravery not just from a foundation of profound cynicism, but from a clinical perspective that it could be another symptom to write on his beloved whiteboard.
“If you look specifically at his actions, they’re all designed for one thing – they’re constructed to benefit the patient,” Kaplow pointed out. “So no matter how outlandish he is, you can always count on House doing the right thing to save a life. I don’t think we can get too outrageous, because so far he’s always been in the patient’s corner.”
This trait, plus the charisma Hugh Laurie adds, gives the writers freedom to push the limits of House’s misanthropy, allowing him to say the rudest comments to make a point, and, for the most part, not horrify the audience or make them wonder too loudly why the man isn’t fired or killed. (He has been sued and punched.)
“He can get away with it, because he’s the one guy you really want on your case if you’re sick,” said Kaplow.
The Issues: “Who’s to say that what House has done is wrong?”
House is the doctor I would most want on my case if I contracted a mysterious disease, and the one I would least want on my staff if I were running a hospital. I often find myself cheering for him, then realizing I really should be opposed to what he’s done – like his lie to the transplant committee in last season’s Kaplow-written “Control,” a lie that put his bulimic and therefore higher-risk patient on the top of the transplant list.
“It’s a grey area, and it’s worthy of discussion,” Kaplow acknowledged. “House is an advocate for his patients, not all patients.”
By presenting complex issues about transplant ethics, clinical trials, and patient rights through such a compelling character, we see his point of view. But one of the most impressive feats of the writers is allowing viewers to make up their own minds. There is something noble but also shortsighted about House, who often lands on the side of individual good over greater good. It’s possible to admire the character without buying completely into his actions, because we understand his motivation to fight for his patients (whether they want him to or not), but we also get Wilson, Cuddy, or Foreman credibly challenging his position.
House’s Vicodin use, flamboyantly used as punctuation in many scenes, is one of those issues that has been challenged, leaving the audience satisfyingly unsatisfied. When the writers deftly delve into the intricacies of House’s warped psychology, such as his drug addiction, they ensure a question is raised for each one answered.
“He takes drugs because he’s in pain, not to get high. That would be his argument,” reasoned Kaplow. “I think it’s a defensible argument. There are lots of people who need pain medication in order to do their jobs, and if they are in pain, they can’t do their jobs.”
“Now, does House take advantage of that?” he continued. “Maybe.”
In “Detox,” we learned that House is dependent on Vicodin physically and, probably, emotionally – he admits the first point, but it’s Wilson who implies the last before backing off. Still, we do see him frequently pop pills before bracing himself to see a patient or his ex-girlfriend Stacy. And since she came back into his life late last season, a suspiciously empty bottle of alcohol has made a few appearances, too.
“We’re going to go deeper with all that stuff as the season goes on, and try to get at the core of what his drug use is – is he just getting high, or is there something else going on,” Kaplow promised.
He is currently writing an episode called “Happiness” – safe money is on that being an ironic title – to air in the new year. “House does some pretty outlandish things in this episode, and it raises the question: is this only about addiction or is he self-destructive?” he revealed. “Does he have some sort of death wish? What does House want in the end?”
The Fun: “We root for him, and we root for his rudeness.”
The show is not all character angst and medical drama. The wickedly clever humour – brought nimbly to life by Laurie, who was best known before House as a comedic actor – is nailed in a series of quotable one-liners and absurd situations, especially involving the clinic patients. (“Well, not everyone can operate a zipper. The up, the down … what comes next?” he mock-sympathizes with the man who tried to perform a do-it-yourself circumcision.)
As entertaining as it is to watch House say and do outrageous things, it seems it’s equally entertaining to write those outrageous lines and actions. “I think some of House’s most adolescent moments are in my episodes,” Kaplow confessed. “House playing air piano, House snorting Benadryl, those sort of things. They’re outrageous but they’re fun. I think we’re all teenagers at heart, and he does the sort of things we’d like to be able to do or say, so writing for him is easy.”
New episodes of House return next week, after a month-long baseball hiatus. Tune in Tuesday, November 1, at 9 p.m. on Fox, or Global in Canada.
(For more on my interview with Lawrence Kaplow, including more of his thoughts on House, the ending to “Honeymoon” as originally conceived, and fan reaction, see the Q&A.)
(Cross-posted to Blogcritics.)