Gradually, I started to love this program. I liked the puzzles, the interesting characters, the hilarious inaccuracies (cardiac arrest in every episode :) ). And there's another important factor here, because House is a doctor with chronic pain, a collection of states which has a fascination for me. One day I will be a doctor dealing with chronic pain, right now I am a medical student dealing with chronic pain and fatigue. So when I watch House, I am in some ways taking a look into my own future.
Now, those of you who have watched House will know that that... isn't a nice thought. House is portrayed as a distinctly unpleasant person. He abuses his friends, he mistreats his colleagues, he is constantly angry and frustrated and blames all of his problems on his painful leg. Oh, and he's addicted to Vicodin, an opioid painkiller, which he occasionally supplements with heroin. He's destructive to himself and to everyone around him apart from most of his patients, who survive by TV medical drama logic only.
So, my question for today is this. Is House an important character, a lone figure representing chronic pain in modern media? Or does he misrepresent pain so badly that the awareness the character generates is overcome by the misinformation that is spread?
Let's start by talking about mood. Being in pain all the time, unsurprisingly, can make you a bit tetchy. Fatigue, which often accompanies pain, can cause a low level cognitive impairment known as brain fog which can make people absent minded and grumpy (from my experience, it's basically like regressing to toddler-hood, I become unable to deal with complex emotions, and kind of devolve to hunger and tiredness). So does this explain House's behaviour? Well... nope. Sorry. Being in pain doesn't give you an excuse to be racist and constantly be cruel to those around you. Also, the way House's unpleasant character manifests is often in the games he plays with the people around him. If he had brain fog and low mood because of his pain, he would not have the energy to come up with complex schemes to toy with the people around him. So, House is just an unpleasant person, I don't think his pain factors in much at all really.
Another thing I think needs discussing is House's ability to accept help. Basically, he... doesn't, except when it suits him. When he's going around day to day, he's very independent. But as soon as as someone challenges him, he is quick to come out with "I'm in pain!" Now, this unsettles me. People with chronic pain often struggle with knowing when to seek help, but they also worry that when they do, people will think they are making excuses, or be suspicious that their pain is too convenient. As in "Oh, so you're in too much pain to come over to see me today, but you were fine to go out and do your shopping yesterday?"
Now, I think I at least over-estimate this a lot. I'm sure most people don't think this, but seeing a programme which makes me suspect someone else with chronic pain of doing this makes me wonder how people for who this is their only exposure to chronic pain would interpret this, and whether it would make people be more suspicious of real people doing this.
So, now I'm going to try and address the big topic of contention in House. Drugs.
A lot of people with chronic pain rely on drugs to get through their days. They let people be independent, they allow people to work. They reduce pain, which, when you have lived with pain for your entire life, is kind of magical. It's an entrancing, seductive thought, that I could take a pill and my pain would go away. But a lot of people see the painkillers and associate them with addiction, with drug-seeking behaviour and recreational use. This then leads to stigma surrounding painkiller use to develop, and subsequently to a reduction in the painkiller's being prescribed. And this leads to people being denied the drugs they need to live their lives, to go out and work or dress themselves in the morning. So basically, the situation is a bit of a mess at the moment.
Just to be clear, I don't have a problem with a chronic pain patient being presented as a drug addict. What worries me is that House is the only character with chronic pain that I can think of starring in a major film or TV series. So as far as representation goes, 100% of portrayed chronic pain characters that I know of are drug addicts. This is not good. In an environment where pain management is so often messed up, this is really, really bad.
Another thing which bothers me is that no other approaches to pain management are seriously considered. House is meant to be smart and willing to try anything to reduce his pain. Cognitive behaviour therapy, physio, counselling, all these have strong evidence behind them showing that they are effective ways of managing chronic pain. You know what really doesn't? Basically any analgesic drug. At the moment, a lot of important questions cannot be answered. No-one can tell me, a 20 year old, what would happen if I started taking 4 doses of paracetamol every day for the next twenty years. Would it have an effect on my pain? Would it have negative side effects? Would I become addicted to it? No-one knows. So if there's one thing that is less believable to me than the constant restarting hearts, it's that House would not try other approaches to help control his pain.
So, is House a good representation of people with chronic pain? No. But I don't think House is the problem. I think the complete lack of other characters with chronic pain is a problem. Representation matters, and people with chronic pain aren't really being represented at all in media at the moment. People with chronic diseases aren't being represented well in the media at the moment. Hell, people with glasses aren't represented well in the media at the moment.
Please, don't judge the chronic pain community by House. But do watch it. It's great for a laugh, and there's some brilliant acting and character development throughout the seasons.
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