Why Take Painkillers for Your Pain When You Can Take Up a Hobby Instead?


In the third season of the usually excellent Fox medical drama House, the writers bravely allowed the title character, the irascible diagnostic genius played by Hugh Laurie, to outsmart a vengeful detective (David Morse) who was determined to make him choose between his career and his Vicodin habit. House entered treatment but continued taking the pills, which he was using to treat chronic leg pain, on the sly. This season (the sixth), the writers seem to have chickened out, which is a shame not just because of the message it sends about pain treatment but because the developing story about House's drug use makes no sense.

Toward the end of last season, House had what looked like a psychotic break, featuring vivid, detailed hallucinations that included repeated visits by the ghost of his best friend's girlfriend and an imagined love affair with his boss. In the last episode of the season, he checked himself into a mental hospital. This season begins with House, still in the hospital, suddenly and dramatically withdrawing from hydrocodone, which is completely gratuitous, since even if there were a reason for him to stop using the drug he could have been tapered off. We are explicitly told that the painkillers were not responsible for the hallucinations, the exact source of which remains mysterious but may have something to do with House's lingering depression. Yet now House's psychiatrist (André Braugher), friends, and colleagues see him as an "addict" who must forever avoid "using." Worse, this is how he describes himself, even though the hydrocodone, which he really did need to treat his leg pain, improved rather than impaired his ability to function.

In this week's episode, House, on the advice of his psychiatrist after he's released from the hospital, quits his job and tries to find a "hobby" to distract himself from the leg pain, which is so severe that it prevents him from sleeping. He and his psychiatrist ultimately conclude that what he really needs is to go back to work, even though the stress and drug-associated surroundings may increase his risk of "using," because that is the only thing that will engage his mind enough to make the leg pain bearable.

This plot is stupid in several ways. First, unless House plans to diagnose disease 24 hours a day, going back to work is not a solution to the pain that keeps him up at night. Second, if all House needed to relieve his pain was his work, why was he taking the Vicodin to begin with? Third, we never get a clear explanation of why House is forever forbidden to use painkillers, no matter how much he is suffering, especially since he managed to do his job brilliantly while he was taking them. The message seems to be that people suffering from severe chronic pain should find engaging work (or a hobby!) to take their minds off their agony, instead of relieving it with medication designed for that very purpose, medication that can be taken indefinitely without serious complications. Why? Because drugs are bad, and if you take them long enough you will become an addict. This cruel, illogical message is guaranteed to offend anyone who has suffered from the kind of pain that afflicts Gregory House, and it only reinforces the misconceptions that, together with fear of legal trouble, already make doctors reluctant to prescribe narcotics even in situations where they are entirely appropriate. 

I was surprised once before by the direction this running plot took, so I suppose I should not rule out the possibility that the show's writers will somehow redeem the medically and psychologically senseless cliché to which they have resorted. But it's hard to see how that can happen, unless House wakes up one day to discover that his new drug-free lifestyle was all a bad drean.

I remarked on House's Vicodin habit here and here. More on the conflict between drug control and pain control here.