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Learning and Dreaming Through House

spleenfiend's picture

Dr. Gregory House looks like a terrible role model.  Despite this, in the popular television serial House, M.D., he is one of the most captivating modern characters on air.  Dr. House is many things, and while he is a jerk, he is also a brilliant doctor.  In nearly every episode, he manages to save a life with his unique type of thinking.  So, we must ask ourselves, should we be more like House, minus the drug problem and cynical attitude?  Is he a good teacher, and can we learn from his thought patterns?  Should we even be learning from a television series that is often unrealistic, even dreamlike at times?  The answers to these questions are almost as complex as House himself.

Teaching comes in many forms, and some would even say we can learn from dreams—though naturally, we can only dream of what we’ve learned.  A television show that is watched for pure enjoyment leaves a lot of space for dreaming and imagining as we view, and if the show has anything to teach us—or if we personally choose to find lessons in the show—then viewing can be a beneficial experience.  Aside from adding new images and experiences (though they are not our experiences or even real ones) to our memories and dreams, television serials can pave the way for new ways of thinking through the information they provide.

House, while a medical drama, is a character driven show, and most of its viewers are not doctors or even future doctors.  For the doctors watching, House is certainly not very medically “educational,” even if treatments and tests are described.   So House is instead watched because people want to see characters like House and Wilson be developed through intricate plot lines, but the majority of viewers are not striving to copy House’s attitude and demeanor.  They just want to observe him.

Still, House is an interesting thinker, which is part of why observing him is so appealing.  Applied to the practice of medicine, the way he thinks only works in the context of the show.  Doctors are sometimes told that “if you hear hoofbeats, think horses, not zebras,” as horses are more likely than zebras.  The diseases that House tends to treat are considered zebras, not horses, as they are such rare conditions. But House is anti-probability, which is strange for someone who is so logical and analytical.  His expertise allows him to be this way, as he tends to be right, but in real life, doctors who "hunt zebras" are not the best.  A doctor like House would misdiagnose and kill many, many patients by always choosing to treat what is probably the least likely cause for the symptoms.   Admittedly, the show acknowledges that he is responsible for most lawsuits against the hospital, but he still saves the most lives in the canon of the show.  House runs ridiculous and expensive tests to find diseases that are not probable in most conditions.  This only works because House’s diagnostic unit is supposed to treat weird diseases, and the show would lose a lot of its formula if House only diagnosed common diseases quickly.

Watching House does expand the viewers’ knowledge of uncommon medical conditions, for better or more likely for worse.  An MSNBC article discusses patients who self-diagnose themselves after watching House.  Like House, they end up thinking every little detail is relevant to the case, but this is not necessarily true.  Dream interpretation falls into a similar trap.  People zero in on small details that they interpret to mean something in context.  In reality, dreams are full of many details, mostly insignificant, and mostly forgotten when they are not considered relevant.  The same can be said of symptoms as well as facts about one’s life that House would take into consideration on the show; that’s why he has his team members search the patient’s apartment to find out everything possible about him or her.  House’s brain works in such a way that if he has every detail, he can combine them with his medical knowledge to link them together and solve the case.  In real life, this is unlikely to work.  The small details House collects can always be attributed to a number of conditions, and the expensive and complicated tests would just waste valuable time except in very rare circumstances.

This House-caused expectation is an annoyance to doctors who are tired of patients incorrectly self-diagnosing themselves, but otherwise not harmful—and it works in rare cases, so it can (almost) only help.  Misinformation is not necessarily positive, and there are plenty of flaws to be found in the medical procedures, and House blogs written by real doctors find these flaws.  Despite this, watching House can be helpful for viewers who are not looking for the correct way to treat a patient.

Dreams are a similar learning experience.  One learns from dreams through interpretation.  On their own, dreams are probably not significant the way Freud thought.  There are many theories about how dreams are formed, the most unromantic being the Activation synthesis theory, which states that dreams consist of the cortex merely trying to make sense of random images produced in the pons.  However, even if dreams “mean nothing,” they can force people to re-examine their relationships or overall situations based on their appearances in dreams.  This confirmation bias may be harmful in a medical setting, but it’s fine for self-reflection.

We can learn from modern media through interpretation as well.  We can process it metaphorically, even if the media is not inherently or intentionally “deep.”  Anything that causes people to think, no matter how, is worthwhile.  House is not a shallow show, and it provides a lot for its viewers to analyze on a deeper level.  It can also certainly seem dreamlike.  To someone who doesn’t know anything about medicine, the way House solves cases appears to be almost magical and unreal.  He can look at a clinic patient and almost immediately solve his or her problem.  This is actually not uncommon for a doctor.  House, Unauthorized, a book of essays that discuss the show, features an article called "How House Thinks." The article states that most doctors are able to tell what is wrong within twenty seconds of meeting a patient, though they can not explain how.  This is a phenomenon that is true of many experts in their fields.  Unfortunately, the thought process that causes the instant realization is little understood and nearly impossible to teach.

Another article in House, Unauthorized, titled “But Can He Teach,” claims that despite House’s impatience and bad attitude, he is a good teacher to his colleagues.  He is not only an expert but models his behavior in an urgent setting where his team has no choice but to pay attention.  However, throughout the show, the members of House’s team never come to think exactly like House.  House is still the star of the show, and he is nearly always the one with the crucial diagnostic moment.  In fact, the show emphasizes not that the other doctors are learning from House’s medical expertise but that they are learning from his cynicism and detachment. 

Foreman is sometimes conflicted that he is becoming too much like House.  In season one, episode eight, he is shown wearing the same pair of shoes as House to show his "transformation"—not just into a great doctor but into an "arrogant jerk" like House.   Later in the show, Chase is the one who is shown as becoming too much like House.  He intentionally kills a patient who is a murderous tyrant, leading to conflict in his relationship with his wife, Cameron.  In season six, episode eight, Cameron gets angry at House and tells him, "You ruined [Chase], so he can't even see right from wrong."  Becoming more like House is a trade-off.  You get the medical expertise, but you also give up your chance at being a well-adjusted person with a normal life.  If you never even master House’s thinking technique, then it’s more of a negative trade-off.

The question “Could House be a good role model?” may very well elicit an instant “no” from any follower of the program.   Still, we can learn from House on a metaphorical level, just as we can learn from dreams on a metaphorical level.  His tendency to “think outside the box” is useful, as is the way he analyzes a situation objectively without letting other people’s past conclusions influence his own ideas.  House is not generally viewed for academic purposes, but that does not mean viewers are passive and do not take away messages from the show.  So long the message you take isn’t “Become a drug addict and be a huge jerk,” the dreaming induced by House is rich and educational.


Anne Dalke's picture

Structuring Learning

what interests me here, first, is your opening conflation of House's "being a jerk and being a brilliant doctor," what you later contrast as "his medical expertise" vs. "his cynicism and detachment."  Do you think that there a causal relationship between these two positions? Is House such a striking diagnostician precisely because he doesn't talk to (and so doesn't get "lied to," or misled by) his patients? Because he is endistanced enough from them to see the disease, instead of the person in whose body it is housed?

This would follow the logic of psychotherapy, which assumes that someone not involved w/ you emotionally is more likely to be able to help you w/ your emotional problems. And it is certainly a theme that plays out in in two episodes in which House and his team treat--but fail to save--Amber; they are too much too emotionally involved to do so objectively. Part of what distinguishes House, as you say, is the "way he analyzes a situation objectively without letting other people’s past conclusions influence his own ideas."

The larger issue which also interests me here is what structures most enable us to learn. You conclude by saying that "the dreaming induced by House is rich and educational." So what exactly makes a situation "educational"? Is a show which is beriddled w/ false diagnoses (as indicated in those interesting House blogs written by real doctors that you found)? Is it one which is (in your description) "often unrealistic, even dreamlike"? Does the educational quality of a show have less to do with "if the show has anything to teach us" than "if we personally choose to find lessons in the show"? That is, that an attitude that wants to learn can be taught, by any scenario?

I had suggested @ the end of class session last week that one impetus to learning might be a pattern of "doubleness," or highlighting a "gap"--w/ something that doesn't make sense (say: the images and words in a graphic narrative, which don't jive w/ one another). That sort of dissonance inevitably provokes thinking, prods the brain to try and make sense, to make coherence....But in ending always w/ a quick Eureka! moment of diagnosis, does House close off such spaces for our thinking?

And what about allowing space for the diagnoses that cannot be made, for the uncertainties that can not be solved? How to decide which details to attend to? (See Lisa Belkin's "Coincidence in an Age of Conspiracy," or "The Odds of That,New York Times Magazine, August 11, 2002, for a very vivid description of our tendency to find patterns where none exist.) Should more of education focus less on"critical thinking" or "the scientific method" (dismissed by the Huffington Post this week as "an educational train wreck"), and more on "the thought process that causes the instant realization," which you characterize as "little understood and nearly impossible to teach"?

In “The Emotional Dog and its Rational Tail: A Social Intuitionist Approach to Moral Judgment.Psychological Review 108 (2001): 814-834 (for example), Jonathan Haidt argues that moral intuitions always come first, and directly cause moral judgments, that moral reasoning is an ex post facto process. Might the same be true for analytical reasoning more generally? That our (quick, "hot," 'cheaper") gut feelings always precede our (slow, "cool," "more cognitively expensive") rationalizations--and that we should learn to trust 'em? Do you think that we can be schooled in how to do so effectively?