Dr. House Tells You What Life is Worth

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This post analyzes the latest episode of House, Last Temptation, for a which a full synopsis is not yet available. But before that, a question:

Say your a chef. Not only do you love cooking, you love eating. Finding new and interesting ways to blend flavors is what makes your day. Just thinking about heading down the spice aisle at Albertsons (ignore the fact that a chef of this caliber probably wouldn’t shop at Albertsons) gets you hard. Unfortunately, you’re diagnosed with a (mythical) disease that necessitates the removal of your taste buds. You’ll never taste again. If untreated, even though you’ll be able to cook, you won’t live for more than a year. Treated, you will live a long life. Do you do it?

The answer will differ from person to person, but it’s an important question every person should ask of themselves: which is more important, quality or quantity of life?

I opened with the taste bud question because eating and tasting food is something every person on the planet enjoys to some extent and can relate to. This is important, because what may be essential to your existence might mean nothing to someone else. You might not have cared about walking across a tight rope strung between the Twin Towers, but to Philip Petit, it was a feat worth over five years of his life.

Time to look at tonight’s episode of House. The patient is a 16 year old sailor. Before she gets sick, she’s preparing herself to become the youngest sailor to ever sail around the world. Late in the episode, the extent of her passion is becomes clear, and I’m paraphrasing from memory: it’s not about the glory and it’s not about the record — it’s about continually besting herself doing what she loves. Most people call this “passion”.

The final diagnosis is cancer that requires the amputation of her arm. Too bad hook-hands are only useful for intimidating your crew, not sailing solo. Ignore the fact that today’s prosthetics might let her sail again (the show ignores it, maybe because they’re lazy and want to create fake drama, but that’s another discussion) and ignore the question of whether or not she’d still be able to get her record (the show ignores that too). Instead, lets focus on how the question, quality vs. quantity of life, is presented (or, rather, not presented).

The episode is told from the POV of Martha Masters, a doctor known for being adamant in her beliefs. One of these beliefs is that the patient’s life is important. Specifically, the greater the quantity of life possessed by the patient, the more good she’s done. This is fine. She’s a character and that’s an interesting angle. The problem is the show executes this premise with stunning lack of awareness.

You might argue that because the episode is told from Master’s POV, she could be an unreliable narrator. It’s a good point, and it would have been a brilliant episode if Master’s treatment of the patient forced her to analyze her own life for meaning, but I don’t think it did. Instead, the conflict is about whether or not Masters has the balls to lie in order to get the arm amputated. It’s never about whether or not amputating the arm is the right decision. Time for the breakdown.

First, when Masters originally delivers the news that the patient’s arm must be amputated, the family kicks her out so they can talk about it. Masters waits in the hall. Moments later, the patient’s father emerges from the room. He informs Masters that his wife has come around to his daughter’s POV and he’s none to happy. He would overrule everyone, but he doesn’t want to upset the family balance.

Strike one: the daughter’s POV (i.e. discussion with her mother) never enters the show. “But the show is told from Master’s POV and she wasn’t in the room!” Easy gentle reader. You’re right if you said that, but just because that’s true doesn’t mean the show doesn’t avoid the question, which is the position I take given what happens next.

Masters asks for advice from other characters in the show. None of them suggests that maybe a person capable of sailing around the globe solo is the one that should be making the decision about their life. Shit, they never say it’s the patient’s decision.

Not even House — the character who had his leg muscles removed against his will, condemning him to a life of pain — offers this argument. All he’s interested in, he tells Masters, is the diagnosis, which is solved. Forget the show breaking its internal rules, which it just did. Just recognize this, the second strike: none of the characters that Masters talks to acknowledge the question of quality vs. quantity of life .

Masters even ends up trying to convince the patient in a tete-a-tete that she has to amputate her arm. This is the scene where the patient tells Masters how good she is at sailing… but fails to bring up any of the aforementioned issues (will she be able to sail again? Break the record? Quality vs. quantity of life?)

At this point, it looks like the patient is going to get out of the hospital and attempt to sail around the world.

Not if Masters has anything to do with it. Masters gives the patient medicine to simulate heart failure, tells the parents her heart failure is because of her cancer, gets them to sign a form giving the hospital permission to amputate the arm, then goes and gets the other four doctors on house’s team to amputate.

Strike three: all four doctors, doctors that know she faked the heart problem, agree to the amputation. Four doctors with what generally are four wildly varying opinions, and each of them has already made the decision that quantity of life is more important than quality .

Perhaps you think I’m going too far. Maybe I am. The patient is a sixteen year old girl after all. She’ll find meaning in something else. And perhaps that’s true too.

But consider this — when you’re among the best in the world at something, you’re not a typical 16 year old. When your the best in the world and you’ve accomplished real, tangible things that hundreds of other people worldwide care deeply about, perhaps admire, perhaps wish they could do, then it’s not as easy as saying “you’ll find something else”. When you’re that good, the best in the world at something, you won’t ever find something like that again. Lightning doesn’t strike twice.

THIS is where you know the episode’s writer fucked up: The character who is the best in the world at something never considers what her life would be like if she couldn’t do that thing. The question of whether or not she’ll still be able to sail, much less break the record in the future, is never raised. If that’s not a contrived plot built to satisfy the needs of the writer, I don’t know what is.

The show ends with Masters having a sleepless night and deciding she can’t work at the hospital anymore. So she leaves. And that’s it. No introspection, no sign she believes she’s done something wrong.

She had a sleepless night? Please. Her patient woke up screaming and cursing everyone around her — anyone would have second thoughts about whether or not they did the right thing. But unless those second thoughts are about whether or not it was right to take away a patient’s passion against their will, they’re empty, meaningless.

And, for the reasons above, there is no reason to believe Masters had such thoughts. If that was the shows intention, well, still shitty writing, though for different reasons. Too bad this episode doesn’t resemble some of its earlier episodes, where asking the question, not providing an answer to it, was the important thing. 

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24 Responses to Dr. House Tells You What Life is Worth

  1. JohnJ says:

    One thing I detest about the whole “quality versus quantity” debate is that it frames the issue in completely narcissistic terms. What about factoring in what will help us make life better for those we love? Aren’t we already self-centered enough?

    • Guy Fox says:

      Quantity vs. Quality, especially in cases of illness, often necessarily implicates the family/loved ones. Someone with ALS, for example, has to watch himself deteriorate, but so does his family. And in many cases, they’ll have to spend a lot of time and energy in the potentially rewarding but generally soul-sapping pursuit of providing comfort for the very slowly dying beloved. If neither party mentioned both sides of the problem, I would still bet that they had all considered it. Extra cc’s of morphine are often the blessing too horrifying to be verbalized.

      There is definitely a narcissism angle, though. I didn’t see the show (it won’t be available in my neck of the woods until y’all are in flying cars), but it sounds as if they did shoot it to show some of Masters’ narcissism. By the sound of it, they didn’t peek into the girl’s head because Masters didn’t try. The doctors were willing to lie and cheat because they privileged their own expertise (of the right way medicine is practiced) over the girl’s and her family’s (about what kind of life she was creating and how to fill it). In neglecting the bigger quantity vs. quality question, they might have been able to show how professional indoctrination (in-doctor-ination?) cognitively forecloses many options that a person would be able to see without the specialized training or with a greater capacity for empathy, no?

    • AlexWolfe says:

      First, I fucked up — the episode does actually state she won’t be able to break the record if she doesn’t sail. Most of what I said remains valid, I think, because (a) the question of her sailing again is never raised and (b) the quality vs. quantity issue is never raised.

      JohnJ — you raise a good point. In fact, that could have been a pivotal discussion point raised in the episode… but it wasn’t. That, to me, was the problem. There was no conflict between the parents and their child over the question of self vs. others — it was assumed the daughter was wrong. Never discussed. Nonissue.

      And that’s what bugged me.

    • Balsamred says:

      Quality vs. quantity absolutely does involve loved ones. My parents had a friend who opted to forgo expensive treatments for brain cancer because they were unlikely to give him more than a few extra months. My mother railed against his selfishness, saying he should have done everything he could for any extra time he could give to his family. On the other hand, not receiving the treatments meant that there was more money left over for his family, who had to learn to cope without their breadwinner, and they had to spend less time watching their husband/father dying in a hospital bed, and were able to move on with their lives sooner. Which is more selfish: to hang on to every last second you can get, regardless of the cost and pain to your loved ones, or to make your decision based on your own desire to avoid or end pain, and thus deprive your loved ones of your presence too early? It’s a very individual decision, and it’s usually not so clearcut which choice is the more selfish or selfless.

      • Dirk Anger says:

        That exact decision is discussed too in the first season of Breaking Bad. Of course, the breadwinner decides to also make meth to leave them some money, but it’s an interesting debate they have.

  2. sdenheyer says:

    This post made me want to chew my keyboard a little.

    As to the issue of character consistency, everything House did in this episode tracked with his character arc. Ever since Masters joined the team, he’s been trying to get her to break the rules – and here, he obviously put the decision in her hands and then feigned apathy to put her in the position of responsibility. The pivotal House line from this episode was (paraphrasing from memory) “You care more about colouring inside the lines then this girl’s life.” Master’s inner conflict between following rules and getting the job done was what this episode was really about.

    I don’t want to come off as overly adversarial, but I feel like I have to say this: if you think trading off decades of life against sailing – or pursuing any single activity – is a question even worthy of consideration, there’s something very badly wrong with your preferences. I consider myself very passionate about what I do (not relevant, but: sound mixing), but I could think of about a dozen things off the top of my head that I could become passionate about if I got ear cancer.

    • foxfire says:

      “I don’t want to come off as overly adversarial, but I feel like I have to say this: if you think trading off decades of life against sailing – or pursuing any single activity – is a question even worthy of consideration, there’s something very badly wrong with your preferences.”

      I would have to disagree. It is a question of priorities and degrees. Different people will draw the line at different places.

      50 years of life as a human vegtable in a coma, vs 1 year of life as a fully function human being? I will take 1 year.

      • JohnJ says:

        “It is a question of priorities and degrees. Different people will draw the line at different places.”

        You know, I don’t really think so. The definition of spoiled might as well be someone who says “If I can’t have a pony, I’d rather be dead.”

        • foxfire says:

          Yes, some people will draw the line there.

          This

          and this

          And finally this

          There are a non-zero sized group of people out their who would rather die and/or kill their families to avoid living with shame. You can call these people spoiled, narcissitic, or whatever other label you want, but the fact remains… People like that exist.

          Relative to those extreme examples, I think someone stating that they would rather live one year chasing their dreams over 20 years as an invalid doesn’t seem all that extreme.

      • sdenheyer says:

        I agree that, at the margins, suicide is a valid option, and where the threshold is is going to vary from person to person.

        But, in the case of the House episode, we’re no where in the vicinity of the margin, we’re at that place where, a year from now, the person says “I can’t believe I was going to kill myself over that.”

        • mwigdahl says:

          … so thank goodness we have strong, white-coated authority figures ready to save us from our own short-sighted folly.

          I think this episode reflects more the increasing infantilization of the average citizen in society than it does the question of quantity vs quality of life. It just goes down easier when it’s doctors overriding your choices rather than, say, the natty-suited bureaucrats of The Adjustment Bureau.

          • sdenheyer says:

            To be clear, I’m not advocating for any practical limits on patient autonomy (more “What can be considered a rational reason for committing suicide?”)

            I think the show is interesting, because it shows us the trade-offs we are forced to make in the interest of respecting this autonomy. (Ya, I’m a bit of a fanboy for this show)

      • philtrum says:

        That one’s pretty simple; permanent unconsciousness isn’t especially distinguishable from death. But what about less profound disabilities (i.e. almost all of them)?

        It’s a truism at this point that able-bodied people think they wouldn’t want to live without the use of their arms and legs, for example, but if they do lose the use of their arms and legs, they grieve, but they adjust. They discover that life is not meaningless and they don’t want to die after all. Disability rights organizations like Not Dead Yet fight pretty hard against this “better off dead” framing.

        I don’t watch House, but to me it seems obvious that a teenager who chooses to die rather than lose an arm is making a bad decision (much like teenage Jehovah’s Witnesses who crop up in the news every now and again, wanting to die rather than accept blood transfusions), so the interesting question for me is whether the violation of medical consent is ever justified.

    • AlexWolfe says:

      “As to the issue of character consistency, everything House did in this episode tracked with his character arc. Ever since Masters joined the team, he’s been trying to get her to break the rules – and here, he obviously put the decision in her hands and then feigned apathy to put her in the position of responsibility.”

      I didn’t think of House feigning apathy. Obtuse of me. You might be right on that. Even so, there are examples from past episodes where House is very vocal about the patient’s choice if he thinks they’re being rational, and given how he acted in DNR from season one, I’d think this patient would fall under that. Still, I can see him not caring about the patient if he thought it would get Masters — he’s logical to the point of being utilitarian.

      • sdenheyer says:

        To be fair, the House character is mercurial, and how he acts depends on the point he’s making (or the writers are making) – but yes, the usual pattern is that House overrides the patient’s preference when he perceives them being irrational. Which is what makes the show interesting, IMO.

        The only time I can think of that he sympathized with a patient’s choice was over a leg amputation (the leg was trapped under rubble in a structural collapse of sort some) – so he’s not without his biases.

  3. mossmanjake says:

    My initial feeling about shows like this is that they’re not really shows. They’re not narratives… not really. They seem like producer-made/writer-room amalgamations of A) Some controversial topical issue, and B) a game of “Would You Rather?” The characters are simply agents of these factors and it doesn’t really matter what they do, because as long as you have a good chance of stirring up a hotbed of emotion, then maybe you’ll get viewers. I don’t know. Just sort of a gut feeling. This doesn’t seem like good art, but it also doesn’t seem like bad art — it doesn’t even seem like careless art. It just seems like non-art, a nothing, inspiring nothing.

    • dimly says:

      I agree with mossmanjake, the main theme doesn’t ask anything and doesn’t resolve to anything meaningful. It simply serves as a false drama and resolution.

      I would however, agree with the OP about the show’s stance toward quantity over quality. The real POV is authority, House et. al. make the decisions. Even when 3/3 members of the family are on the same side of the decision (to varying degrees).

      They even go so far as to allude to the fact that exceptionalism isn’t worth the effort. Masters broke the rules to reach achievement, but no one ever said that achievement and fulfillment walk hand in hand.

      The episode was actually about the chickens. Because what else can every first-world relate to and enjoy? Wanton tomfoolery, brightening up your long trite life.

  4. boeotarch says:

    This wouldn’t be the first time House has gotten rid of a character in a contrived and nonsensical way: they had Kumar kill himself for no reason and had every other character instantly forgot it happened. My guess is this episode is a product of external casting/production/contract issues and not really an attempt at art.

  5. BluegrassJack says:

    Up-front disclosure: House is my favorite TV program.

    Kumar had plenty of reasons to commit suicide. All the writers had to do was pick the best one of them.

    The type of cancer that the 16-year old sailor had POSSIBLY could have led to a long and happy life for her, if her left arm had first been amputated. The girl told everyone within earshot that accomplishing her sailing goal was the most important thing in her life.

    Olivia Wilde will be welcomed back. She does have one of the most interesting backstories of any of the many emotionally-crippled doctors seen every week.

  6. Comus says:

    So let’s see here:

    We’ve got Masters, an extraordinarily brilliant doctor, even by House standards, a prodigy. We have the girl, an extraoridnary sailor, a prodigy.

    We’ve got Masters deciding on whether to go on with Houses department, or to choose another, less intellectually stimulating life of a genius somewhere else. being on the House team is like being chosen as the Nobel of the Nobels (the best nobelist of all nobelists). We also have the girl deciding whether to risk death and became the best of the best, or amputate an arm and live what is probably a long and mediocrish life.

    We’ve House campaining on Masters to lie, cheat and commit criminal acts. We’ve got the mother codeciding with the girl that she should keep her arm and be spectacular. (why does mom want this? BIRF: basking in reflected glory)

    We’ve got Masters’ friends saying that it’ll be a whole lot of badness working with house, and it’s her call whether she can cope with it. We’ve got the girl saying that there are a lot of things she hates about sailing, and still takes this as the only main interest in her life.

    We’ve got the constant bombardment of game. The who_can_keep_a_chicken_the longest -game, the control over the dog, ie. the fetch game. Sailing. The alphabetizing of diseases. Paper planes.

    Who plays games? children. Like the sailing girl.

    So what I’m getting at is that the writing is actually quite clever. They have no need to portray any self-reflection (it’s implies though, on many occasions), as the whole thing with Masters is parallelled by the girl. The girl is an extra. She is there to emphasize the key elements in Masters’ decision.

    She, like Masters is a one trick pony. Sailing is her whole life, she’d kill herself for it. Medicine is Masters’ whole life, taking the internship with House is akin to death in many ways. In an analogous move taking away the girls arm in order to have her alive coinsides with the decision to decline the internship to keep intact an integrated self-image. A deal with House is a deal with a devil. He’d repackage your personality with cheats, lies and immoralities. So the ultimate question is , are you ready to lose yourself for being extraordinary? The girl is just a child and decides to go with the instant gratification of yes, I’ll be best and probably die. Masters, the girl doing paper airplanes and all-in-all being very childish, grows up.

    Paradoxically in this move she claims superiority, as she reclaims control, even over House, by declining the position.Maybe she is extraordinary after all.

    I think the brown (of House) and the white (of Wilson) chicken are supposed to symbolise good and evil, in this case lieing and being honest. So when Houses dog catches Wilsons chicken, this allegorises the dishonesty that Masters will commit, but in the end it is still Wilson who wins the bet and Wilson prevails, ie. Majors reflects and decides that dishonesty is not for her,

  7. edumds says:

    at one point Masters asked Wilson about House’s behaviour, the dialogue goes like this:

    Wilson: he didn’t want to operate his leg, entered into a coma, his girlfriend signed the consent to do the surgery probably saving his life

    Masters: so she did THE RIGHT THING.

    Wilson: DEPENDS WHO you ask.

    The show does present the question even if en passant, House has been through the exact same situation and pulls the Pilate eventually.

  8. ThomasR says:

    Disclaimer: I do not watch House. I think it is an interesting, but not particularly entertaining show.

    The episode, as described by AlexWolfe and others in the comments, is one of the most disturbing things I’ve ever read. I’m not the best at anything, but there are many things in my life that if I had to choose between losing them and death, I might choose death.

    And the idea that someone would take away my freedom to choose is terrifying. The doctor should have her license removed, and potentially charged criminally.

    IRL, the hospital would have to pay this family hundreds of millions of dollars in the lawsuit.

    Note: I am talking about dying, not committing suicide, which is a different (though related) can of worms.

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