Much like the pilot of CSI, the series starts with no need to introduce the various characters and explain the motivation. Instead, we get a teaser where a school teacher (Robin Tunney) starts speaking gibberish before having a seizure, and only then are we allowed to get our first glimpse of Gregory House (Hugh Laurie), head of the Diagnostics Department at Princeton Plainsboro Hospital in New Jersey. At first sight, one would never guess he's a doctor, and not just because he refuses to wear a lab coat: he's rude, acerbic and refuses to shave, plus he walks with a cane because of chronic leg pain to which he responds with far too many pills. In addition, he diagnoses patients without ever seeing them, since he believes total detachment is necessary to crack the "case".
Not that he does any of this alone: he has a team of assistants, which includes neurologist Eric Foreman (Omar Epps), immunologist Allison Cameron (Jennifer Morrison) and Robert Chase (Jesse Spencer). Apart from being regularly insulted by their boss, they run all the tests and occasionally break into people's homes to find out what might be wrong. Not exactly part of the team, but important nonetheless, are oncologist James Wilson (Robert Sean Leonard), House's best (and only?) friend, and Lisa Cuddy (Lisa Edelstein), the misanthropic physician's boss.
This opening episode is a practically perfect combination of three separate efforts (the only defect is the purple-ish cinematography that doesn't occur in the rest of the show): firstly, there's Shore's script, which manages to do to medicine what Aaron Sorkin did to politics, namely make the subject interesting with the assistance of fast-paced, smart dialogue and none of the sloppy sentimentality that characterizes Grey's Anatomy; then there's the director (and executive producer) Bryan Singer, who took a break from superhero films to concentrate on a smaller, character-driven mini-movie, albeit one where his familiarity with special effects does come in handy sometimes (one sequence in particular, where the mysterious disease is headed towards the patient's brain, reminds of the opening credits of the first X-Men).
And last but not least, there's the essential ingredient of quality TV: a good ensemble cast. Everyone pulls it off admirably, with a special mention for Leonard who hadn't been in anything this relevant since Dead Poets Society, but in every scene it is clear that House would only be half as good as it is if it weren't for Laurie, who does the best job of his career: throwing away the flamboyant insanity of his British television roles (Blackadder etc), he nails the required American accent perfectly and infuses his postmodern Holmes-like role with a healthy does of sarcasm that goes along well with the cynical seriousness, most notably when he quotes the "philosopher" Jagger: "You can't always get what you want". A neat summation of his view on life, and one of the countless reasons to watch the show.
He gets right to the heart of the matter, whether it is someone that is dying, or someone who is a hypochondriac, or a mother that thinks she knows more than her doctor does.
He doesn't mince words, and believes all people lie.
This episode introduces the characters we will grow to love and introduces the best medical show on television.
Directed by Brian Singer, who gave us X-Men and X2, this is one exciting show.
So why not exactly a great pilot, or rather something that could right away be one-upped? I think, really, it has to do with the direction from Bryan Singer, and specifically a technical decision. I know some may admire how Singer and his DP put a sort of purple-ish tint on the whole episode, but it just does not work, at all, especially in the context of the rest of the series which does not feature it again. It's a choice that didn't add anything dramatically to the episode, except perhaps to be something akin to what's done on CSI. It's too much of a distraction in scenes that should just be focused squarely on not getting in the characters/actors' way (the constant tracking shots, a trademark since the days of ER, is paramount), and keeping the mood tense during the moments of crises with the patient. It's not that it isn't decent what Singer's doing with Shore's material, and most notably this comes with the shots going inside of the patient's system to see what's going wrong, a visual effect probably taken from Singer's days doing X-Men. But that one tint makes what is otherwise an excellent pilot a downer.
In this episode, a young kindergarten teacher, Rebecca, collapses in her classroom after she starts talking gibberish. She is now under the care of Dr. Gregory House, and his team of find diagnosticians. House is quite bitter, and rude, but you still can't help but love him. His team, including Dr. Foreman, a guy who annoys me for some reason, Dr. Chase, who annoys me because of all the inside Australian jokes he makes throughout the show (I'm Australian, so it's okay), and Dr. Cameron, more than just a pretty face, all help him solve the case. House also has to answer to Dr. Lisa Cuddy, his boss, but makes her life a little bit harder everyday. And House's best friend, Dr. Wilson is just awesome.
Overall, I give this episode an 8 out of 10, which in my ratings book is: Awesome.
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 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, with our central protagonist finally stumbling upon a possible solution as a result of treating his far less challenging patients in open clinic. 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 negative 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 curiosity is piqued by the fact that the patient's condition does not respond to radiation treatment. 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 experiemental 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. 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 reveal them to be a failed Jew, 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. Despite the fact that Robert Sean Leonard maintains that this remains his favourite episode ever, as House maintains 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.