The Houseification of American Medicine
How Chronic Illness became a Myth to Millions of Americans
The first time I was what I would call *very sick* was in my senior year of college. I had to drop out of all but two courses and then move back home with my mom to get school done.
During those months my comfort TV of choice was House M.D. with Hugh Laurie and among others, an Olivia Wilde untainted by the years since.
For those who never have had the joy, Laurie plays an American infectious disease specialist who solves unsolvable medical ailments like a immunology Sherlock Holmes. Similarly, Dr. House suffers his own vices like drug addiction and the inability to form bonds with people around him.
It is still one of my favorite shows despite its incredibly early-mid oughts obsession with dressing women in horrendous patterns and favoring them starvation-thin, and all of the misogyny that lays underneath those kinds of choices.
Laurie plays a complex, good hearted human operating in a healthcare system that devalues life in favor of profit. He suffers from his own disability that leads him down the path of addiction. He becomes cynical and beaten down by the reality of illness and the bigness of the job in front of him.
The supporting cast have their own relationships to healthcare and to each other and to their careers as doctors, all explored in depth. I would put the series’ ending in the top five ever executed.
But it has very much changed in meaning to me. At the time, I didn’t understand that I would likely be sick for the rest of my life. I was incredibly hopeful that I would somehow find my own Dr. House, who would begrudgingly treat me and find some rare disease and cure me within the course of an episode.
A decade later, I do in fact have a diagnosis, but it is not one that lends itself to the tidy rhythms of prime time. Mine is a chronic illness with very little treatment options that are finally being addressed because of its relationship to Long Covid.
But chronic illness (except for cancer) does not appear in our American medical story. Shows like House and Grey’s Anatomy have taught viewers that when presented with a problem doctors will pursue that problem until they have an answer. In that world, those who stay sick are sick by choice — if they really wanted to get better, they wouldn’t stop until someone cured them.
Why don’t you just go to the doctor?
The reality is much murkier. Doctors do not have the freedom to endlessly pursue a diagnosis. Especially if a patient comes into the emergency room, doctors are taught to treat anything life-threatening and then get a patient out of the hospital (House practices in a hospital, as do the Grey’s cast). The patients you see on shows like this who are maybe low on iron or have a cough, or are simply being held so that a doctor can figure it out, those patients don’t exist in real hospitals.
Our healthcare system is intrinsically woven into the monetization of specialist’s time. Quick fixes are economically viable — mysteries are not. And even when a patient is lucky enough to fight for a diagnosis (I myself have been to about 18 different specialists in my quest), many times that diagnosis doesn’t have a cure.
This lack of treatment is in fact another symptom of our American healthcare system, wherein women’s diseases (80% of immune related diseases affect women) have historically been ignored or diagnosed as mental health symptoms. Those looking for diagnoses like Long Covid or Chronic Fatigue Syndrome may even have trouble finding doctors who believe the diseases or symptoms are real.
Research has instead gone toward more profitable ventures like Viagra, orthopedics, and other male-centric medical issues. Because our pharmaceutical companies are profit-driven centers, this kind of work takes priorities. Nonprofit medical research driven by organizations like the National Institute of Health have seen declining funding for decades.
But House helps us to suspend that reality for a little while. It is a realm of belief in the goodness of people who won’t give up no matter what, where money does not matter and a patient is assumed to be telling the truth. There is a beginning, middle and end to a patient’s diagnostic timeline that leaves viewers feeling hopeful or devastated as they watch a tragic untimely death.
The messy truth of illness
This craving for the story arc is what leads many to dismiss the reality of those with chronic illness. Upon diagnosis, there is no end to the journey they’ve been on. Many live with the same symptoms that can only sometimes be improved by treatment. They live in the middle of that story for the rest of their lives. You as the viewer of their life don’t get the satisfaction of watching them get better.
House and shows like it have warped our idea of the American medical system by giving us the false belief that the majority of people who are unwell get better. We have been trained to believe in the infallibility of medical providers by our primetime drip of medical dramas. We believe that when a doctor can’t find the answer, one doesn’t exist, or a patient is exaggerating their symptoms.
The truth is that many will live with symptoms that are never diagnosed, either because our system does not incentivize doctors spending time to reach a diagnosis, or because the patient couldn’t afford care in the first place.
Acknowledging this truth helps us to decouple health from personal responsibility in a way that medical shows cannot. Factors like misogyny, medical fatphobia, lack of training, medical school curriculum, insurance-imposed time constraints, and more, don’t exist in these dramas.
When we put those back into the story, the picture comes in to much better focus. Truthfully, many people are living the best lives they can with the medical care they can afford or find.
Bridging the gap between drama and truth
So, what do we do with shows that portray medicine as a more precise science than it is in practice? Should we disregard them entirely? I think no.
Similar to the best practice for media involving the justice system, it’s important to think of these portrayals as a reality outside of our own. If we prioritize the truth of the people in our lives instead of the fiction, they can teach us how to want more for the people we love.
The compassion and empathy available to the doctors in medical procedurals is something that we as people should aspire to. We should want to create a world where Dr. House could actually practice. We should want to study the diseases that keep people chronically ill and hopefully find treatments.
But seeing each other clearly, and especially disabled folks clearly, requires our understanding that these shows are not close to reality. The neat story arc we want from TV can’t be what we want from our sick friends.
The hope many disabled people have is not that they will get better, but that they will build a full life anyways. They yearn for years filled with people who believe them and who treat them like they’d treat any other friend. They yearn to use their energy cultivating their humanity instead of barely surviving in our financial system that disregards their existence.
There is room for so much joy in a life with chronic illness (I can attest to this) but it requires people to ditch the scripts on disability that they’ve been fed by our medical media. When we treat the fiction like the fiction, we can start to see the truth more clearly, and to carve out a world that is better on and off our TV screens.