House and Philosophy

The name Dr. Gregory House, M.D., combines three of Sir Arthur Conan Doyle’s famous fictional detectives: Sherlock Holmes, John Watson, and Tobias Gregson. The last name House is a synonym for home, which is how Holmes pronounces his name (though with an “s” at the end). The medical initials in House’s name, “Dr.” and “M.D.,” are also those of Dr. Watson, Holmes’s trusted friend and assistant. But then Watson and Holmes are, in turn, also based on two real-life medical doctors. Conan Doyle was a practicing physician in his own right, and he looked up with awe, as Watson looks up to Holmes, to Dr. Joseph Bell, M.D., of the Royal Infirmary of Edinburgh, whose character, profile, and seemingly magical powers of detection became those of Holmes.² House’s first name, Gregory, is a little harder to spot, but it’s right there in the first Holmes adventure, A Study in Scarlet, in the form of Scotland Yard detective Tobias Gregson. Holmes tells Watson that Gregson is “the smartest of the Scotland Yarders,” essentially “the pick of a bad lot.”³ Gregson brings Holmes his hardest cases, the ones he can’t solve, just as Cuddy brings her hardest cases to House when no one else at Princeton-Plainsboro Teaching Hospital has even a clue. Gregson’s and Watson’s intellectual limitations are important because they reflect the reader’s dumbfoundedness about Holmes. They provide the perspective we need on the genius we’re not. Likewise, we could hardly sympathize, let alone identify, with the brilliant House without all his personal and physical difficulties. They humanize him, just as Watson and Gregson humanize Holmes.

And like Holmes, too, House always has help: a team of young doctors at his beck and call. These are House’s Watsons: Cameron, Foreman, and Chase, each with a different specialization. They are not, however, friends or confidants to House, as Watson is to Holmes. That role is reserved for House’s fourth Watson, his peer Dr. James Wilson, who shares Watson’s initials: “Dr. J. W., M.D.” Wilson also lives with House for a time, just as Watson and Holmes share rooms on Baker Street. Together these four neo-Watsons engage House with the questions we, the viewers, have about the case, just as Watson engages Holmes on the progress of the case. They are how we get close to a genius. Otherwise, we would have no way in. House and Holmes are not open people. They’re loners, unmarried, unconnected; they care little for others, and can be curt and insulting even to their assistants. In fact, all they really care about is solving the case. They live for the rush of investigation, nothing else. Everything is geared toward that end: their academic pursuits, their musical interests, their seeming recreational activities, even their drug habits—all of it is a means to the final end of knowing whodunit.

Among their parallels, the most important is methodology. Both Holmes and House conceive their logics as deductive, and both are quite wrong!⁵ All great fictional detectives mistake their methods as deductive, and most, like Holmes, simply scoff at guesswork: “I never guess.” But Holmes does guess (The Sign of Three),⁶ as do all detectives and all medical diagnosticians. House also mistakes his method as deduction: “Figuring requires deductive reasoning” (“Acceptance”); and: “I mean, because he said that it hurt and I should have deduced that meant it was sore” (“Occam’s Razor”). If House and Holmes, however, truly did use deduction, then their inferences would be entirely error-free and guesswork-free, because in deduction, if the premises are true, then the conclusion must be true. For example, given two true premises, “All doctors make mistakes” and “House is a doctor,” we know with certainty our conclusion: “House makes mistakes.” We know our conclusion with certainty because we know something about all doctors: namely, that they make mistakes. There’s no conjecture or probability about it. But none of Holmes’s inferences follow with necessity. They’re all conjectural. They’re very good conjectures, but conjectures just the same.

Cuddy is actually doubly wrong here. She’s wrong about doctors prescribing medicine on guesses; they do, all the time. She’s also wrong about the equation of unethical medicine with lack of deductive validity. All medicine, ethical or unethical, and all science, for that matter, is ultimately a matter of conjecture. House knows all this, and he knows, too, that what really bothers Cuddy is the lack of proof in House’s method. But House accepts this lack of proof in his inferences as the essence of medicine—again, despite his mistaken self-assessment of a deductive method, as in this exchange from “Pilot”:

House: There’s never any proof. Five different doctors come up with five different diagnoses based on the same evidence.

Cuddy: You don’t have any evidence. And nobody knows anything, huh? And how is it you always think you’re right?

House: I don’t. I just find it hard to operate on the opposite assumption. And why are you so afraid of making a mistake?a

Championing a method riddled with error, House appears almost opposite Holmes, who brags to Watson his method is error-free: “There’s no room for a mistake.”⁷ Holmes backs it up, too: he’s virtually always correct, so his successes just further fuel his overconfidence, but they shouldn’t, because—for all his success—every single case is fraught with a mistaken understanding of methodology. House, however, never makes this mistake about making mistakes. He makes them all the time, but he knows making them only gets him closer to the truth. He understands that the fallibility of his guesswork logic is essential to his method—and House, at least in this respect, is superior to his alter ego Holmes.

On the other hand, Holmes, to his credit, spends far more time in self-analysis. So we know more about his method, which means we have more to criticize as well as praise, while House keeps his methodological cards closer to the vest, much to our chagrin. We’d like to hear more from this Holmesian master about what it is he thinks he’s doing, especially when it comes to logic and reason, and the reading of clues. We’d like to hear something like this:

Most people, if you describe a train of events to them, will tell you what the result would be. They can put those events together in their minds, and argue from them that something will come to pass. There are few people, however, who, if you told them a result, would be able to evolve from their own inner consciousness what the steps were which led up to that result. This power is what I mean when I talk of reasoning backward, or analytically.⁸

Passages like this one reveal something important about Holmes. He may be wrong about deduction, wrong about error, and wrong about guesswork. But his analysis of deduction, or what he calls “reasoning backward,” looks strangely familiar, and exactly like guesswork. We begin with a result in the present, an effect, and then track the development of that effect back in time along a continuum looking for a cause. Often we run into error because multiple causes could explain a single effect, and there’s just no deducing the right one. It has to be a guess, and it’s achieved exactly the way Holmes says it is.

There are three steps in abduction. First, the surprise, an anomaly; medicine runs on them, as House points out: “Doctors love anomalies” (“Acceptance”).¹¹ Faced with the anomaly, House seeks to explain its causal source by means of a rule that would render that anomaly a matter of course. What possible pattern in nature, or culture, would cause this result? Reasoning backward in time, from effects to causes and back again, House selects the most likely cause, and then orders the tests to see if he’s right. Of course, again, it’s only a guess, a conjecture. And he could be wrong. But even if he’s wrong, still, at least then he has new information and can now make a better abduction.

Part of the reason abduction runs into error so often, from a logical point of view, is that it’s invalid, meaning there’s no sure way of saying if our conclusion will be true, even if our premises are true. So, for example, we could begin with a surprising result and formulate a pretty good rule that explains that result, but we could easily be wrong all the same. The conclusion will never (and can never) follow from the premises with necessity. But then again, abduction doesn’t pretend to demonstrate once and for all that a conclusion simply must be the case. All an abduction provides is a reasonable hypothesis as to what could be the case. It’s more than a shot in the dark, but sometimes not much more.

House: Unfortunately you have a deeper problem. Your wife is having an affair.

Man: What?

House: You’re orange, you moron. It’s one thing for you not to notice. But if your wife hasn’t picked up on the fact that her husband has changed color, she’s just not paying attention. By the way, do you consume just a ridiculous amount of carrots and megadose vitamins? [Man nods.] Carrots turn you yellow, the niacin turns you red. Find some finger paint and do the math. And get a good lawyer.

House begins with the first result: a man is orange. But if the man ate lots of carrots and megadose vitamins containing niacin, then he would turn orange. Therefore, he probably eats carrots and niacin. A second result emerges. No one else has noticed the change in color, and the man wears a wedding ring. But if his wife were having an affair, then that would explain her lack of interest in him—and indeed later we see she was having an affair.

The more interesting cases, however, are those House takes by choice and that require undercoded abductions. After the symptoms are catalogued, House gathers his team. One by one they generate possibilities to explain the anomalies. House writes these on a wipe board. Some are eliminated as too improbable, others for inconsistency with the symptoms. Gradually the possible diagnoses are reduced to a few. These are then organized hierarchically according to likelihood and efficiency of testing. The cycle of testing and abduction continues until the right diagnosis is in hand, and House has solved the case.

House: The tumor is Afghanistan. The clot is Buffalo. Does that need more explanation? Okay. The tumor is Al-Qaeda, the big bad guy with brains. We went in and wiped it out, but it had already sent out a splinter cell, a small team of low-level terrorists, quietly living in some suburb of Buffalo, waiting to kill us all.

Foreman: Whoa, whoa, whoa. Are you trying to say that the tumor threw a clot before we removed it?

House: It was an excellent metaphor. Angio her brain before this clot straps on an explosive vest.

At first, Watson doesn’t quite understand what’s going on with the strange swing of Holmes’s mind. But gradually he learns this zombielike trance is an essential and prior step to solving any very difficult case. After assimilating clues in the hunt, Holmes will retreat to his rooms on Baker Street and sink deeply into his armchair, listening to music, with “a dreamy, vacant expression in his eyes.”¹⁶

Peirce calls this pre-abductive dream state “musement” and defines it as the “pure play” of the imagination. After all the clues have been gathered, the detective must pull back from the case, relax his eyes, and retreat into his imagination. There, wild visions and diagrammatic scenarios of causality flash by. All the results and all the possible rules are shuffled about, as the detective looks for the perfect fit.¹⁷

Likewise with House: he, too, has two sides, though they are not nearly as extreme as those of Holmes. At one moment, House is mad with energy, standing before the wipe board with all the various possible diagnoses written before his team, yelling at Cameron and Chase and Foreman, yelling at Cuddy, and even swatting them with his cane. But then he’ll stop, almost all of a sudden, and retreat back to his office, kick back, and enter the Holmesian musement state, gently waving his hand back and forth, drifting in a logical delirium as he listens to John Henry Giles’s (Harry J. Lennix) jazz recording, as he did in the episode “DNR.” This scene in House was virtually taken right out of Conan Doyle’s “The Red-Headed League”:

All afternoon he sat in the stalls wrapped in the most perfect happiness, gently waving his long, thin fingers in time to the music, while his gently smiling face and his languid, dreamy eyes were as unlike those of Holmes, the sleuthhound, Holmes the relentless, keen-witted, ready-handed criminal agent, as it was possible to conceive.¹⁸

Entering either the musement state or the “sleuthhound” state, Holmes was also known to rely on intoxicating drugs. House’s drug of choice is Vicodin, partly because it kills pain and allows him to focus on the details of the case, but also for its euphoric and relaxing, contemplative effects; in other words, because it enhances the musement state and allows him to form better undercoded abductions. ¹⁹

In one particular case, however, House is truly stumped. He finds himself not only alienated from his team, but even his own mind. He’s been shot twice point-blank in his office by a man named Moriarty (“No Reason”).²⁰ The name is important because it’s also the name of Holmes’s archnemesis, Professor James Moriarty, who appears in “The Final Problem” and The Valley of Fear. A true criminal mastermind, Moriarty is every bit Holmes’s equal in genius: “I had at last met an antagonist who was my intellectual equal.”²¹ And Holmes has nothing but the utmost respect for Moriarty’s powers:

He is the Napoleon of crime, Watson. He is the organizer of half that is evil and of nearly all that is undetected in this great city. He is a genius, a philosopher, an abstract thinker. He has a brain of the first order. He sits motionless, like a spider in the centre of its web, but that web has a thousand radiations, and he knows well every quiver of each of them.²²

Having bested so many of London’s criminals, Holmes now finds himself at the very center of the web of crime, opposing the leader of all the criminals, and so it is a fitting ending when, after so many great adventures, Moriarty finally kills Holmes. But the death is an illusion. For in “The Adventure of the Empty House,” Holmes miraculously returns, much to Watson’s amazement: “ ‘Holmes!’ I cried. ‘Is it really you? Can it indeed be that you are alive? Is it possible that you succeeded in climbing out of that awful abyss?’ ”²³

This cycle of murder and rebirth is imitated in “No Reason,” after Moriarty shoots House and leaves him for dead. House wakes up near death, in a hospital bed next to Moriarty, who has also been shot, by security guards. Always the arrogant diagnostician, House thinks he’s already solved his own case: he knows why Moriarty did it. But House is wrong. His diagnostics are off, and Moriarty can see right through him as House struggles to talk with his team. He’s slower after the shooting. Something happened to his mind. Usually he has to lead his team through the case, but this time they’re off and testing before House is done reasoning. Even Chase, the slowest of the three, is too fast, too good. House is disturbed, but Moriarty is not surprised, and he delights in taunting the so-called master: “Maybe he knew the answer because the question wasn’t nearly as tricky as you thought. Maybe he’s not getting smarter. Maybe you’re getting dumber” (“No Reason”).

But even if House is slower, he knows Moriarty knows too much. He knows, too, the time continuum seems a little broken. And all of a sudden, he can walk without a cane and his leg pain is gone. Steadily the anomalies build up around him, and House makes the abduction that he is hallucinating. Moriarty doesn’t really exist. He’s inside of House’s mind. Chase isn’t really brilliant, and his leg isn’t really better. But with his new abduction in hand, House is now struck with a further result: he cannot break free of the hallucination by will alone. But if he were to attack his own unconscious mind, which is producing the hallucination, then that might break the spell. In order to achieve a sufficiently graphic and effective attack on his mind, House murders his own patient in cold blood.

In murdering his patient, House uses what Lorenzo Magnani calls “manipulative abduction”: “manipulating observations to get new data, and ‘actively’ building experiments.”²⁴ And here, too, House is Holmes’s descendant. For, just before their first meeting, Watson learns Holmes has been beating dead bodies to coax clues. Watson’s old friend Stamford says: “When it comes to beating the subjects in the dissecting-rooms with a stick, it is certainly taking rather a bizarre shape.” Watson can barely believe it. But Stamford assures him: “Yes, to verify how far bruises may be produced after death. I saw him at it with my own eyes.”²⁵

Likewise House will often give a patient a mix of medicines, or cause her undue stress, in order to reveal other symptoms. And now he must do the same on himself: he must manipulate his own mind to derive new data. And it works. House suddenly awakes to find himself being wheeled into the emergency room, barely conscious, having just been shot. House has, by this point, made three abductions: that he is hallucinating, that breaking his ultimate oath will break his hallucination, and that he may yet cure his leg pain. Earlier in his hallucination, reading his chart, he found that ketamine was administered, and he demanded an explanation from Cuddy, who provided it: “There’s a clinic in Germany. They’ve been treating chronic pain by inducing comas and letting the mind basically reboot itself ” (“No Reason”). That explained his newly painless leg (but not the sudden muscular development). House realizes that he was no more talking to Cuddy than to Moriarty. He was talking to himself, and even unconscious, he was working out an abduction for a cure to his pain. Barely conscious, House utters only one sentence: “Tell Cuddy, I want ketamine” (“No Reason”).

Of all the lines ever quoted from Sherlock Holmes, the most famous is certainly this one: “It’s elementary, my dear Watson.” Everyone knows it. The problem is, Holmes never said it.²⁶ Still, he might as well have, given his habit of regularly insulting the slow-witted Watson. House does the same with his team. But he is perhaps most cruel to Cameron, who loves him. They have dinner once, and Cameron wants to talk. It’s just so simple, she thinks: they can be together, if only he’d try. After all, she knows that on some level he wants her. But it’s just as clear to House that they can’t be together. So, instead of romantic conversation, House ever-the-sleuth delivers his diagnosis, callous and direct, as though Cameron were laid out on a hospital bed, rather than dressed to the nines for an intimate evening. She is broken, and she falls in love with broken men; she treats them as projects to work on. Now she’s chosen him because he’s broken, too.

As she hears her diagnosis, she knows it’s true. But what she doesn’t know, and what House doesn’t seem to know either, is why exactly he’s broken. It’s not lack of love or leg pain or even drug addiction. These are symptoms, not causes, and besides, House was House before the infarction (muscle death) in his right leg, the same guy he’s always been. His illness, rather, is logical: or, abductive, to be more precise; and it’s progressive and degenerative. The better House gets rationally, the worse he gets psychologically. The abductions become faster, his perception more fine-tuned. This one overcoded, that one undercoded, two at once, all day long: inferences about his team and their problems, Cuddy, a rat, a guy in the park, anything and anyone, God, and the human condition. He just can’t stop; and as many Vicodins he tosses back, they’re no relief from his magnificent gifts. The true tragedy of House is abductive reason run amok in the mind of a mad genius who, like all mad geniuses, must ultimately self-destruct.

2 Christopher Morley, “In Memoriam,” in The Complete Sherlock Holmes, 8; and Thomas Sebeok and Jean Umiker-Sebeok, “ ‘You Know My Method’: A Juxtaposition of Charles S. Peirce and Sherlock Holmes,” in The Sign of Three: Dupin, Holmes, Peirce, ed. Umberto Eco and Thomas Sebeok (Bloomington: Indiana Univ. Press, 1983), 30-31.

5 A further interesting parallel is the common use of a cane. House uses one to support a bad leg. Holmes uses one, too (but rarely). In “The Adventure of the Speckled Band,” Watson says: “The instant that we heard it, Holmes sprang from the bed, struck a match, and lashed furiously with his cane at the bell-pull” (Doyle, The Complete Sherlock Holmes, 271). And in “The Red-Headed League,” Watson says: “The light flashed upon the barrel of a revolver, but Holmes’s hunting crop came down on the man’s wrist, and the pistol clinked upon the stone floor” (Doyle, The Complete Sherlock Holmes, 189). A hunting crop is a kind of cane.

17 Peirce writes that in musement “those problems that at first blush appear utterly insoluble receive, in that very circumstance,—as Edgar Poe remarked in his ‘The Murders in the Rue Morgue,’—their smoothly-fitting keys. This particularly adapts them to the Play of Musement” (“A Neglected Argument for the Reality of God,” in The Essential Peirce, vol. 2, 437). Note further that Sherlock Holmes was based on Edgar Allan Poe’s character C. Auguste Dupin, who also relies on the musement state to solve cases.

The Game’s Afoot

House and Holmes

House’s Logic

House’s Abductions

Musement and Abduction

House vs. Moriarty

It’s Elementary, My Dear Cameron

NOTES