Dr. Grinch is in the House

House, M.D. is a twist on the hoariest of TV genres: the medical drama. After decades of Marcus Welby wannabes, each more unrealistically warm and fuzzy than the last, we've come to question the gap between the doctors on TV and the ones who make us wait hours to get in, ignore us in favor of our chart and kick us out the door with the speed and efficiency of that Santa in A Christmas Story, the one whose carnie-like elves dispatched the kid on the lap by use of a slide. No matter how many ads we see - for hospitals and pharmaceuticals - nothing can replace the reality that doctors often treat their patients like luggage.

Thanks to creator, David Shore, you don't have to wonder what TV would be like if the tube gave its audience a little taste of reality. House, M.D. is just as unreal as all the other hospital dramas, but it has the unsettling - and refreshing - gimmick of being the one hospital show on TV that presents doctors as technicians.* Physician Gregory House is the last guy you'd associate with Marcus Welby, M.D. He limps through corridors sans white lab coat, wearing a three-day-old beard, bug eyes and a snarl that makes him look like the Grinch. And that's if you see him! House hates dealing with patients, considers himself a diagnostician (giving him the excuse that he can cure you from his office while watching a medical drama on a mini-TV) and replaces euphemism with sarcasm.

The reason for the limp, as we find out in Episode 1, was a medical condition that was never fully treated in time. A muscle in his leg began to die, leaving House in debilitating pain, which he treats through generous use of Vicodin. Ironically, that same pain gets worse when he has to deal with clueless patients, causing House to hit the Vicodin again and again. It may well be that his Vicodin is a form of Ritalin, however, since House is the Rain Man of medical diagnostics. The energy he doesn't spend on social niceties is intensely focused on the treatment of strange and elusive illnesses, turning House into a bizarre medical Sherlock Holmes - or what Sherlock Holmes would be like if Sir Arthur Conand Doyle had presented a real cocaine addict with accuracy.

This is, of course, the replacement of one medical myth (the warm and fuzzy doctor) with another (the doctor who has all the time and resources to cure anything). To make that more palatable, the series is set at a mythical Princeton research center, where doctors have the resources to get the most appealing medical mysteries. To do what he does (without necessarily getting his hands dirty), House has a staff of younger doctors, in residency, whom he can abuse and disagree with at whim.

Dr. Allison Cameron (Jennifer Morrison) is the loving, caring, physician who seeks to build relationships with patients, sometimes at the expense of the truth. Her tact often conflicts with Houses's bluntness, leading to an ongoing debate between truth and diplomacy. Dr. Eric Foreman (Omar Epps) is the black physician, chosen by House for his street sense, even though doing so relies upon stereotypes that grate on Dr. Foreman's attempt to be recognized for his own accomplishments, not for what people see when they think of a "black doctor." The third member of the team is Dr. Robert Chase (Jesse Spencer), a playboy-like Australian whose quiet charm masks a more narcissistic concern for by-the-numbers medicine).

The immediate conflict that sets the pilot into motion is House's contempt for hospital rules, which has led to a procedural crisis. His new boss, Dr. Lisa Cuddy (Lisa Edelstein) is a stickler for managerial details - including the hospital requirement that each physician spend a set number of hours at the clinic. Having blown off the requiremment for years, House now owes hundreds of hours in his own personal Hell of dealing with patients in the clinic. Thus the season's big question, played out one episode at a time, is how a physician this antisocial is going to make it in a clinic whose patients bring out the worst in what some would consider to be a very bad man.

And that's the delightful irony of this show: For while House bristles with contempt for patients and their endless questions and needs, his technical emphasis makes him an expert hunter of the medical mystery. Creator David Shore has invented a delivery device for dramatizing an endless number of truly amazing medical mysteries. This is pure believe-it-or-not stuff of the kind that would curl Ripley's hair. And while the dramatizations are purely fictional, the issues are not. House presents the best world of quasi-documentary-style medical case histories but with the flash of great drama.

As for production values, this is a show that rewards the viewer by updating the presentation of medical dramas with cutting-edge direction and style. In the old days, the medical drama involved stagey, crusty, old talking heads, with physicians getting their information by interviewing patients. House, on the other hand, repudiates the patient interview (House thinks all patients lie) in favor of bringing the audience along for a trip through the life of the patient BEFORE he or she showed up complaining of this or that. We don't have to be "told" what's wrong because House, M.D. "shows" us in the first five minutes of the storyline. Each episode, we get a snippet, a kind of slice of life, interrupted by a medical mystery.

Ironically, that means that instead of relying on a narrative - such as a patient's chart or a "medical interview," we begin each episode with an emergency of sorts. People collapse. They seize up. They go into choking spasms. Their lives stop on a dime because of illnesses that are hiding from us. In the same way Six Feet Under would feature a death at the beginning of every episode, House gives us a crisis in progress.

Another nice feature is the integration of explanation and cgi graphics. While each episode features its own suitcase full of medical babble, medical problems and solutions are often graphically portrayed through action-packed computer graphics that put us in the blood stream, take us through the heart, show us blood clots racing through the brain, whatever.

So, while the aim of each story is to take us through a medical mystery, much of the drama is filtered through the tirades and tantrums of a petty, egotistical doctor at war with everyone else in the hospital, who just happens to have a knack for going on micrological bear hunts, even if doing so puts him at odds with the rules. Gregory House, it turns out, is the Dirty Harry of medicine - and watching him smash his way through case after case is a lot of fun.

Each disc comes with extra features, including background material on the cases, information about the cast and "making of" vignettes that are well worth watching.

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* I was a big fan of the under-appreciated CBS medical drama, Chicago Hope, whose quirky, dark, angry doctors were a lot more interesting than the classic healers of ER. Alas, the public likes classic good guys better than fractured people - but House revives the bold and daring attitude of Chicago Hope, and with a vengeance.