House MD starts off in a very smart way because, with the exception of a few moments in some scenes, it could be any other episode. The show's structure from episode to episode relies on it being a case by case basis for the doctors to work on, and this one involving a kindergarten teacher (Robin Tunney), who collapses suddenly in her classroom while teaching, isn't exclusive as being something that could only happen in a pilot episode ala alien abduction in The X-Files. This goes for House's clinic cases too, in this case being a man who's completely orange (looked like someone out of Willy Wonka for a moment) and a boy who can't figure out what asthma is. Already creator/writer/producer David Shore sets up the dynamics of House's personality- acerbic wit, sometimes razor-sharp, but he does care deep down about what he does even it takes a lot, like the patient not wanting to live anymore in Tunney's case, for him to show it. And already right away Hugh Laurie displays his incredible ability to balance out how a man with quick thinking (usually with the conceit of 'oh, I just got it while talking about something else') and a cynicism that comes with the job, and a leg problem.
So why not exactly a great pilot, or rather something that could right away be one-upped? I think, really, it has to do with the direction from Bryan Singer, and specifically a technical decision. I know some may admire how Singer and his DP put a sort of purple-ish tint on the whole episode, but it just does not work, at all, especially in the context of the rest of the series which does not feature it again. It's a choice that didn't add anything dramatically to the episode, except perhaps to be something akin to what's done on CSI. It's too much of a distraction in scenes that should just be focused squarely on not getting in the characters/actors' way (the constant tracking shots, a trademark since the days of ER, is paramount), and keeping the mood tense during the moments of crises with the patient. It's not that it isn't decent what Singer's doing with Shore's material, and most notably this comes with the shots going inside of the patient's system to see what's going wrong, a visual effect probably taken from Singer's days doing X-Men. But that one tint makes what is otherwise an excellent pilot a downer.
So why not exactly a great pilot, or rather something that could right away be one-upped? I think, really, it has to do with the direction from Bryan Singer, and specifically a technical decision. I know some may admire how Singer and his DP put a sort of purple-ish tint on the whole episode, but it just does not work, at all, especially in the context of the rest of the series which does not feature it again. It's a choice that didn't add anything dramatically to the episode, except perhaps to be something akin to what's done on CSI. It's too much of a distraction in scenes that should just be focused squarely on not getting in the characters/actors' way (the constant tracking shots, a trademark since the days of ER, is paramount), and keeping the mood tense during the moments of crises with the patient. It's not that it isn't decent what Singer's doing with Shore's material, and most notably this comes with the shots going inside of the patient's system to see what's going wrong, a visual effect probably taken from Singer's days doing X-Men. But that one tint makes what is otherwise an excellent pilot a downer.