Quality TV makes a 'House' call

So how does one write a House script? A typical episode follows a formula as strictly as a Zen monk's Morning Prayer.

Stage One: The Cold Open. Before our opening credits we need our introduction to the Affliction-of-the-Week. Familiar to most TV viewers, a cold open is used with impunity in cop shows such as Law and Order. Like cross hairs on a gun going from person to person, we can never quite be sure who going to turn into the diseased wreck that allows House to go postal.

Stage Two: The Referral. House is usually at his tantrum-throwing best here. He demands and schemes his way into taking a case he finds interesting, or, Cuddy tricks and bullies him into taking one that he (initially) doesn't.

Stage Three: The Differential Diagnosis.. House grandstands before his whiteboard goading his team into suggesting possible diagnoses ranging from the mundane to the bizarre.  We can never be sure if House secretly knows the answer and likes to test his team as a sort of deranged training exercise, or if he is desperately seeking a solution himself. Either way, he manages to insult each of his doctors with his unique style of divide-and-conquer provocation.

Stage Four: The MRI. Not being a doctor, I can't say whether it's realistic for all patients to invariably be swallowed into this oppressive looking technology. It has considerable horror effect (maybe it's just done to justify an expensive-looking set).

Stage Five: Detective Work. This can be made up of:

1. Sparring between House and nemesis-of-the-week (Cuddy or patient to stand in if in between nemesis arcs).
2. Cuddy self righteously revoking House's patient due to his unconventional methods and shameless behaviour.
3. A touching Wilson-House exchange in which Wilson berates House for being a House (will Wilson ever learn?).
4. An illegal break in of the patient's house or place of work, and the subsequent detective work to find pathogens.
5. A patient has a catastrophic failure, usually while in dramatic mid-sentence, or, even better, while deep in the MRI. This requires sudden violent convulsions, foaming of mouth, beeping of equipment, resuscitation by crash-cart, cries of "Ohmygod, the kidneys are failing", and spontaneous afflictions requiring makeup work that would put Star Trek to shame.
6. Some ridiculous time deadline due to imminent death unless tests can be completed and/or a cause found.
7. A confrontation with a rotten lying liar (namely, the patient, or the patient's parents if patient is unconscious or underage).
8. A (gasp!) misdiagnosis, usually blamed on the lying liar and/or a “cottage” and/or a meddling Cuddy.
9. Much incredulity that House actually wants to interact with a patient and/or shows some unexpected humanity.

Stage Six: Sexual Tension. Choose between Chase-Cameron, House-Cuddy, House-Cameron, House-Patient, Wilson-hospital employee or patient, or any other combination of the above. Foreman doesn't get to play.

Stage Seven: The Resolution. The episode must end with the patient either recovered or dead. Death is no obstacle to achieving the all-important Final Diagnosis.

Optional: some resolution or advancement to some relationship dynamic (required during nemesis arcs).

Add zeitgeist and pop culture references and quasi-familiar medico-babble. Repeat seventy five times (and counting). Result: House.

Perhaps aware of the risk of repetition, the formula is being increasingly varied. This weakening of The Formula has caused existential angst - for me anyway - like there is something fundamentally wrong with the (House) universe. The supporting characters are weaker. Foreman is given a House-like position at another hospital. He becomes a caricature, losing the gravitas he needed to resist House's immature posturing. He tries to treat his team with the respect he was never shown by House (a little prematurely in hindsight), and, ironically, is sacked for being too House.

So, is House going downhill? I suspect (and hope) not. Foreman has been re-hired. Some of the new "cottage" applicants have great potential. Henry 'Bosley' Dobson (played with characteristic gravitas by Carmen Argenziano), a fraud non-Doctor who wins House's respect, is predictably fired due to the risk of upstaging God. Being admired by House is traditionally the kiss of death.  Another character, "Cutthroat Bitch" (her official name, aka Amber, played by Anne Dudek) is similarly feted to leave, according to The Hollywood Reporter. The producers appear to have decided to go with “cottage” clones played by Kal Penn, Olivia Wilde (the bisexual Alex Kelly from the OC) and Peter Jacobson for ongoing roles. I guess nothing beats sticking to formula.