Character Analysis: Dr. Gregory House, Research Paper Example

Aired by the FOX Broadcasting Company, the television series House, M.D., more universally referred to as House, recounts the exploits of Dr. Gregory House and his team of diagnosticians at the fictitious Princeton Plainsboro Teaching Hospital (PPTH) in New Jersey. The collaborative efforts of David Shore and Paul Attanasio are to be credited for the show’s creation. Attanasio conceived the premise for the show, while the show’s protagonist, Dr. Gregory House, was developed by Shore, using Sherlock Holmes as his inspiration. Three companies are responsible for the production of the series, and four people including Shore, Attanasio, Attanasio’s business partner Katie Jacobs, and movie director Bryan Singer, are the show’s executive producers. Although House is mainly categorized as being medical drama, the show also integrates comedy and mystery into its format. Despite the purported east coast location of PPTH, House is mostly filmed on FOX’s studio set in Century City, Los Angeles. House premiered on November 16, 2004 and is currently in its sixth season.

British actor Hugh Laurie portrays the American protagonist Dr. Gregory House, who, like the title of the show, is most commonly referred to as House. House is both brilliant and selfish in equal measure. A medical genius specializing in infectious diseases and nephrology, he is reputed to be a doctor “devoid of bedside manner and wouldn’t even talk to his patients if he could get away with it”, and is instead acerbic and brutally honest (Shore, Attanasio, Jacobs & Singer, 2004). House’s decisions and diagnoses are largely guided by his belief that, “Everybody lies”; a phrase popularized by the show, and common to the show’s vernacular (Shore et al., 2004). House suffers from chronic post-operative debilitating leg pain, resulting from his surgery to bypass dead tissue in his quadriceps muscle caused by an infarction in his thigh. House was given Vicodin to relieve the pain, to which he is now addicted.

Robert Sean Leonard was cast as Dr. James Wilson, the Department Head of Oncology at PPTH, and House’s admitted only true friend. The other main characters on the show are Lisa Cuddy, played by Lisa Edelstein, who is the hospital’s Dean of Medicine, and a series of fellow diagnosticians on House’s team, with Dr. Eric Foreman, Dr. Allison Cameron and Dr. Robert Chase in recurring key roles.

The character presented by Shore et al. through House, lacks remorse, as indicated by a persistent disregard for safety of self or others. House also exhibits consistent irresponsibility, evidenced by a repeated failure to sustain consistent work behavior and meaningful relationships with others. For example, at the show’s outset, House had fallen out of Dr. Cuddy’s good graces as a result of blowing off six years of required clinic duty.

The reasons House acts the way he does seems two fold. Firstly, his behavior could be caused by psychological damage or some mental condition, possibly stemming from his dysfunctional childhood or post-traumatic stress from his expulsion from the Medical School at Johns Hopkins University (JHU). Although House was not physically or mentally abused as a child, and excelled academically in his studies, he did come to learn that he was the product of his mother’s extra-marital affair with the local minister. Furthermore, despite perfect marks on his Medical College Admission Test (MCAT), and being well poised for a prestigious internship at the Mayo Clinic, House was caught cheating, resulting in JHU proceedings to expel him. House eventually finished his medical studies at the University of Michigan.

Dr. House’s callous and at times bizarre behavior appears to be attributed to Narcissistic Personality Disorder (NPD). This assessment is aligned and further supported by character biographies describing House as a misanthrope, cynic, condescending, and narcissistic. Per the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders, to be officially diagnosed with NPD, an individual must exhibit five of the seven specified symptoms which revolve around:

…a pattern of grandiosity, need for admiration, and sense of entitlement. Often individuals feel overly important and will exaggerate achievements and will accept, and often demand, praise and admiration despite worthy achievements. They may be overwhelmed with fantasies involving unlimited success, power, love, or beauty and feel that they can only be understood by others who are, like them, superior in some aspect of life (APA, 2005).

Further, according to Mayo Clinic, House suffers from nine of the sixteen symptoms of Narcissistic Personality Disorder. The following section describes House’s behavior in context to these symptoms, and how they support a diagnosis of Narcissistic Personality Disorder.

House frequently expresses disdain to others he feels are inferior, with a particular contempt towards devoutly religious individuals. House once mocked nun, telling her that the belief in things that are not real was “a job requirement for you people” (Shore et al., 2004b). In another episode, House belittles a fifteen year old faith healer, by comparing faith to ignorance, and emphasizing his ridicule for individuals who believe in something with no proof at all (Egan & Showalter, 2006).

Uncharacteristic of a seasoned medical professional, House also addresses others with no consideration for their feelings, regardless of whether they are a patient, friend or peer. Even his admitted best and only true friend, Wilson, is not immune to the emotional effects of House’s callousness. During the 2007 season of the show, Wilson gave House a rare book as a Christmas present. Wilson would later find out the following Christmas that House never even opened his present, but instead used it as a prop in a team exercise. Wilson was clearly hurt, yet House somehow managed to deflect the blame, indicating that there was no way for him to know the gift was an expensive book, and he didn’t have a need for gifts anyway. In the context of his patients, House typically makes them wait as long as possible before seeing them. During a fit of frustration, House went so far as to tell a group of patients that “a monkey with a bottle of Motrin” was qualified to treat them (Kaplow & O’Fallon, 2004). He has referred to patients as liars, morons, idiots and people not worthy of a second chance.

Specifically, House’s personal and professional misconduct indicate that he believes that he is better than others and acts accordingly. Take for example House’s addiction to Vicodin. In admitting his addiction to Wilson, House says “I said I was an addict. I didn’t say I had a problem. I pay my bills, I make my meals. I function” (Kaplow, Moran & McCormick, 2005). This statement exemplifies his frame of mind that his ability to function, despite his addiction, make him better than others with the same dependence. In another episode, Living the Dream, House kidnaps a soap opera star and brings him to PPTH. House has diagnosed the actor as having a brain tumor based solely on House watching the actor deliver his lines on the televised soap opera. When the actor does not agree with House’s diagnosis, he attempts to leave. House, determined to prove his point, sedates the actor against his will in order to administer an MRI. In this episode, House has broken the law and subjected the hospital’s accreditation to undue risk, yet he makes a plea to the fellows to talk to the actor and convince him not to press charges (Hess & Friedman, 2005). House’s behavior supports his belief that because he correctly diagnosed the actor, his felonies should be forgiven.

His teams of diagnosticians, if not the Dean of Medicine herself, are expected to agree with, if not follow, House’s ideas and plans; failure to do so results in belittlement and ridicule. In the season 4 episode, No More Mr. Nice Guy, after being forced to write his employee’s performance reviews, House tells Cuddy her outfit makes her look like an Afghani prostitute. In the same episode, after Kutner happily identifies the alternate condition other than sexual contact causing a patient’s syphilis, House tells young the fellow to wipe the idiotic smile off his face (Hoselton & Shore, 2008).

There is pervasive behavior in taking advantage of others to satisfy personal, often unrealistic, goals, which is closely tied to House’s inability to maintain healthy relationships. Much like Watson was to Sherlock Holmes, Wilson is House’s primary source for narcissistic supply. A concept introduced by psychoanalyst Otto Fenichel, and further elaborated by Otto Kernberg, narcissistic supply are the emotions of other people that the narcissist uses to stimulate their psychological needs. While House has admittedly named Wilson as his best and only real friend, self-serving interests are a primary driver for the friendship. Although Wilson admires House for his medical acumen, and genuinely cares more for House on a personal level, even Wilson agrees that their relationship shows signs of co-dependency, with Wilson acting as the enabler. For example, Wilson prescribes House with Vicodin and often makes excuses, even going so far as to risk his own career, to get House out of trouble. Consistently throughout the show, Wilson puts House’s needs above his own, and is always there whenever House needs him. In this way, Wilson provides House, the narcissist, “with an obsequious, unthreatening, audience and with the kind of unconditional and unthinking obedience that confirms to him his omnipotence. [Wilson is] sufficiently vacuous to make the narcissist look sharp and omniscient – but not so asinine as to be instantly discernible as such. [He is] the perfect backdrop, never likely to attain centre stage and overshadow their master” (Vankin, n.d.).

Important to note, the Narcissistic Personality Disorder is a complex and often misunderstood personality disorder.  While House, like many narcissists, exhibits a grandiose sense of self-importance, the veneer masks a very fragile and low self-esteem. Though the narcissist may appear tough-minded and unemotional, it is a cover for the shame and humiliation felt inside. The narcissist’s grandiose behavior exists to validate his sense of self-worth. Since the narcissist is incapable of affirming his own value, the narcissist needs admiration from others. However, because the narcissist’s extremely fragile sense of self can not handle any criticism, as it would validate the narcissist’s perceived worthlessness, meaningful emotional connections with others are avoided.

The disorder’s namesake is the handsome Narcissus, of Greek myth, who had a boastful and callous demeanor, and remained unapproachable despite those who tried to befriend him. He eventually fell in love himself, after spying his reflection in a pool of water. Always trying to convince his beloved to join him, Narcissus never left the pool. He stayed by the water’s edge until he withered away and died alone (Minster, 2009).

To a certain extent, narcissistic behaviors are present in all people, but are especially pervasive in narcissists like House. These behaviors are a means of protecting the narcissistic individual from suffering a narcissistic injury. More specifically, a narcissistic injury is the narcissist’s reaction when they feel degraded by another person, typically their source of narcissistic supply. The most pervasive defense is the pattern of grandiosity, need for admiration, and sense of entitlement. The narcissist relies on these elements to validate his inflated perception of self. Typically the defense is invoked when the narcissist’s grandiosity is threatened as a result of someone saying something which conflicts with the narcissist’s inflated view of himself. The narcissist will then suffer a narcissistic and will respond by inflating their grandiosity to a higher level, thus restoring their concept of self.

The most extreme form of narcissism involves the perception that no separation exists between the narcissist and others, their objects. The latter is viewed as an extension of the narcissist, in the context that the narcissist considers others to be integrated with him. Usually, the narcissist merges with objects that represent aspects of the narcissist’s personality which they feel inferior or inadequate about. For instance, if a narcissist feels ugly, he will seek to merge with an object who the narcissist perceives to be beautiful. Narcissists like House, of slightly elevated awareness, have a similar mindset. The narcissist is able to separate self from object, however they views the object as similar to himself in the context of sharing a similar psychological makeup. Essentially, the narcissist perceives the object to be modeled after them, which is why House is able to maintain a relationship, albeit a flawed one, with Wilson. The most developed narcissistic personality distinguishes the object as both separate and psychologically different, but can not value the object as a unique and distinct entity. The object is valuable to the narcissist only to the extent of its ability to enhance the false self.

Narcissism is fundamentally a defense mechanism. The narcissist cannot regard people, events, entities (diseases, his workplace, whatever) as a compendium of good and bad elements. The narcissist adopts an “all or nothing” mindset, and his behavior follows suit. The narcissist either idolizes his object or devalues it. The object is either perfect or flawed. In devaluing an object, the narcissist will always project, displace or externalize what he perceives to be their bad attributes. The opposite reaction is exhibited for objects the narcissist idolizes, as a means of supporting his inflated sense of self, as well as the grandiose fantasies of the narcissist. To reiterate, the narcissist will invoke these defense mechanisms to avoid narcissistic injury, as well as the painful reality leading to the deflation of their over-exaggerated sense of self.

House’s earnestness and his lack of empathy make those around him wonder whether he is simply disillusioned about reality, or willingly and knowingly distorts reality and reinterprets it, subjecting others to his view of the world. After watching House, M.D. for the past six seasons, I would disagree that House’s actions are completely self-serving. Yes, House routinely lies to patients, colleagues, subordinates, and superiors. He manipulates others to get what he wants, and quite often this involves distorting reality to present his take on it. However, House’s deceitful behavior is typically aimed at convincing others, whether patient, peer, or dean of medicine, to agree to an unorthodox method of treatment. While these treatments may seem impulsive or injudicious on the surface, House’s experience and breath of knowledge in the field of infectious diseases provides a sound basis for his recommendations. Unlike other narcissists who are only dimly aware of the implausibility of their own warped sense of reality, House has not lost touch with the real world. He is just less conscientious about reshaping reality and ignoring societal protocols to satisfy his personal quest for knowledge while providing patients with a cure for what ails them.

Works Cited

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR. 4th ed. District of Columbia: American Psychiatric Association, 2005. Web <http://allpsych.com/disorders/personality/narcissism.html>.

Egan, D. and Showalter, J. (Producers). (May 25, 2006). House vs. God. [House M.D.]. Century City: FOX Broadcasting Company.

Hess, S. and Friedman, L. (Producers). (May 5, 2008). Living the dream. [House M.D.]. Century City: FOX Broadcasting Company.

Hoselton, D. and Shore, D. (Producers). (April 28, 2008). No More Mr. Nice Guy. [House M.D.]. Century City: FOX Broadcasting Company.

Kaplow, L. and O’Fallon, P. (Producers). (November 23, 2004). Paternity. [House M.D.]. Century City: FOX Broadcasting Company.

Mayo Clinic. Narcissistic Personality Disorder. Mayo Clinic, 2005. Web. <http://www.mayoclinic.com/health/narcissistic-personality-disorder/DS00652/DSECTION=symptoms>.

Minster, Christopher. “The Myth of Echo and Narcissus.” Suite101.com, 03 Oct 2009. Web. 3 May 2010. <http://greek-history.suite101.com/article.cfm/the_myth_of_echo_and_narcissus>.

Shore, David, Attanasio, P., Jacobs, K., and Singer, B. (Producers). (2004a). House M.D. [Television series]. Century City: FOX Broadcasting Company.

Shore, David, Attanasio, P., Jacobs, K., and Singer, B. (Producers). (2004b). Damned if you do. [House M.D.]. Century City: FOX Broadcasting Company.

Vankin, Sam. “The Narcissist and His Friends.” Buzzle.com, n.d. Web. 2 May 2010. <http://www.buzzle.com/editorials/4-14-2005-68541.asp>