The show's creator, David Shore, writer and executive producer on other long-running series such as 'Family Law', has revealed that the inspiration for the show was an unfortunate experience he had as a patient at a teaching hospital at the hands of a particularly misanthropic doctor. He was also determined to base the central character of Dr Gregory House on Conan Doyle's most famous literary creation. Both share an uncommon flair for deductive reasoning, and both become dependent on one confidant and companion, with Dr Wilson performing this role for House as Watson did for Holmes.
In securing the role of this cantankerous yet ingenious expert in diagnosis, Hugh Laurie had to submit an audition tape recorded in a cramped, darkly lit, Namibian hotel bathroom, as he was in the midst of filming the remake of the 'Flight of the Phoenix'. The series producer, Bryan Singer, had been adamant that the titular role be given to an American actor, and was so taken in by Laurie's American accent that he failed to recognise the actor's true origins. With regards the casting of Wilson, though in the process of auditioning for 'Numbers', the opportunity of playing the sole companion who can tolerate House's sardonic contempt drew Robert Sean Leonard to this project instead.
With regard to the story development, this pilot, the first of ten episodes across the eight series to be penned by the creator himself, established the long-running format which would characterise every episode. This involves House and his team working on various possibilities, and, through trial and error, narrowing down potential treatment. In this pilot, the plot centres on a young kindergarten teacher, who begins to babble incomprehensibly before suffering a seizure. In another nod to Holmes, this patient, played superbly by Robin Tunney, is named after the only female to have ever bested, and affected emotionally, the great detective, Irene Adler.
House's first reaction to the prospect of taking on the case at Wilson's bidding is in rejecting it is a simple case of a brain tumour. However, his involvement and that of his team is triggered both by Wilson's falsely stating the patient is his own cousin, and his jibe that House's team are highly-qualified but sitting around getting bored. What follows is an engrossing fight against time for House and his young diagnostic team to pinpoint the cause of her symptoms and the reasons behind the series of reactions to their experimental treatments.
Meanwhile, a wonderful sub-plot to further establish our protagonist's curmudgeonly attitude towards patients has House contend with being taken to task by the hospital adminstrator, Dr Lisa Cuddy, for not fulfilling his own clinical duties, and blocking his team's tests until he does so. Laurie excels in the series of acerbic dismissals of the clinic patients' lack of medical awareness and misplaced self-diagnoses which follow. Among these are the 'Orange Man', whose issue is quickly attributed to an excess of carrots and certain vitamins, but to which House astutely adds that any wife not reacting to such a stark physical change suggests she is having an affair.
A further illustration of House's outspokenness and lack of concern for political correctness relates to how he treats his team, and in particular, his frankness concerning their selection. Not only does he reveal that physical attraction played a part in Dr Cameron's joining the team, but also that it was Dr Foreman's juvenile criminal record which made him a valuable addition. Thus, in a wonderful exchange, House persuades the latter to break in to the patient's apartment to try and uncover any evidence as to the patient's condition.
Having failed in treating the patient with steroids for what House believed was a case of cerebral vasculitis, or inflammation of the blood vessels, our kindergarten teacher tires of the experiments and demands to be left to go home to die with dignity. It is at this juncture that the weakest aspect of plot development links Foreman's 'break-in', and causal observation that the contents of the patient's fridge with House's astonishing 'leap' to a successful diagnosis. This is that the patient is suffering from 'Neurocysticercosis', which is a condition brought about by ingestion of a tapeworm from insufficiently cooked pork. This could have occurred years earlier, during which time the eggs have left the digestive system, passing into the bloodstream and flourishing everywhere, including the brain. The tapeworm only becomes detected by the body's immune system as it dies, causing the infected area, in this case the brain, to swell.
It is the last of House's trio of assistants, the largely overlooked Dr Chase, who arrives at the solution of X-raying the area to show the presence of a tapeworm, thereby allowing House finally to visit the patient firsthand and appeal to her to give them one last opportunity to cure her. It is at this point that our kindergarten teacher earns her name, and uses her sharp psychoanalysis of House's character to challenge his standpoint that as "everybody lies' the practitioner should deal with the illness and not the patient. As such, Adler wonders whether this is House's veiled sub-conscious protecting his own psyche faced with his paranoia that no one wants to be treated by a doctor with a walking cane.
Despite the fact that Robert Sean Leonard maintains that this remains his favourite episode ever, with House maintaining this shadowy influential presence while the team do the work, the episode fared badly, with many reviewers questioning how such a caustic character could attract audiences. How wrong they were.
In securing the role of this cantankerous yet ingenious expert in diagnosis, Hugh Laurie had to submit an audition tape recorded in a cramped, darkly lit, Namibian hotel bathroom, as he was in the midst of filming the remake of the 'Flight of the Phoenix'. The series producer, Bryan Singer, had been adamant that the titular role be given to an American actor, and was so taken in by Laurie's American accent that he failed to recognise the actor's true origins. With regards the casting of Wilson, though in the process of auditioning for 'Numbers', the opportunity of playing the sole companion who can tolerate House's sardonic contempt drew Robert Sean Leonard to this project instead.
With regard to the story development, this pilot, the first of ten episodes across the eight series to be penned by the creator himself, established the long-running format which would characterise every episode. This involves House and his team working on various possibilities, and, through trial and error, narrowing down potential treatment. In this pilot, the plot centres on a young kindergarten teacher, who begins to babble incomprehensibly before suffering a seizure. In another nod to Holmes, this patient, played superbly by Robin Tunney, is named after the only female to have ever bested, and affected emotionally, the great detective, Irene Adler.
House's first reaction to the prospect of taking on the case at Wilson's bidding is in rejecting it is a simple case of a brain tumour. However, his involvement and that of his team is triggered both by Wilson's falsely stating the patient is his own cousin, and his jibe that House's team are highly-qualified but sitting around getting bored. What follows is an engrossing fight against time for House and his young diagnostic team to pinpoint the cause of her symptoms and the reasons behind the series of reactions to their experimental treatments.
Meanwhile, a wonderful sub-plot to further establish our protagonist's curmudgeonly attitude towards patients has House contend with being taken to task by the hospital adminstrator, Dr Lisa Cuddy, for not fulfilling his own clinical duties, and blocking his team's tests until he does so. Laurie excels in the series of acerbic dismissals of the clinic patients' lack of medical awareness and misplaced self-diagnoses which follow. Among these are the 'Orange Man', whose issue is quickly attributed to an excess of carrots and certain vitamins, but to which House astutely adds that any wife not reacting to such a stark physical change suggests she is having an affair.
A further illustration of House's outspokenness and lack of concern for political correctness relates to how he treats his team, and in particular, his frankness concerning their selection. Not only does he reveal that physical attraction played a part in Dr Cameron's joining the team, but also that it was Dr Foreman's juvenile criminal record which made him a valuable addition. Thus, in a wonderful exchange, House persuades the latter to break in to the patient's apartment to try and uncover any evidence as to the patient's condition.
Having failed in treating the patient with steroids for what House believed was a case of cerebral vasculitis, or inflammation of the blood vessels, our kindergarten teacher tires of the experiments and demands to be left to go home to die with dignity. It is at this juncture that the weakest aspect of plot development links Foreman's 'break-in', and causal observation that the contents of the patient's fridge with House's astonishing 'leap' to a successful diagnosis. This is that the patient is suffering from 'Neurocysticercosis', which is a condition brought about by ingestion of a tapeworm from insufficiently cooked pork. This could have occurred years earlier, during which time the eggs have left the digestive system, passing into the bloodstream and flourishing everywhere, including the brain. The tapeworm only becomes detected by the body's immune system as it dies, causing the infected area, in this case the brain, to swell.
It is the last of House's trio of assistants, the largely overlooked Dr Chase, who arrives at the solution of X-raying the area to show the presence of a tapeworm, thereby allowing House finally to visit the patient firsthand and appeal to her to give them one last opportunity to cure her. It is at this point that our kindergarten teacher earns her name, and uses her sharp psychoanalysis of House's character to challenge his standpoint that as "everybody lies' the practitioner should deal with the illness and not the patient. As such, Adler wonders whether this is House's veiled sub-conscious protecting his own psyche faced with his paranoia that no one wants to be treated by a doctor with a walking cane.
Despite the fact that Robert Sean Leonard maintains that this remains his favourite episode ever, with House maintaining this shadowy influential presence while the team do the work, the episode fared badly, with many reviewers questioning how such a caustic character could attract audiences. How wrong they were.