It seems hard to believe PUBLIC tv could grasp the issues of pain any better than the writers of House.
“Me, I’m a freak. I get off on not being in pain”–Dr. Gregory House
Of course House has to have elements the public can relate to. However, the writers keep slipping in subtle themes that are so central to pain that they are palatable AND entertaining. Who would have guessed. Maybe House can be some sort of role model for CP sufferers. He refuses to get involved intimately with people because he realizes there is a gap between them. Others simply cannot grasp what pain means to the psyche. Yet,he is very much everyman, and that is the irony. By ignoring most of what concerns humans and what they think they ought to worry about, House perceives fundamental truths about what really matters. His intelligence gives him ultimate vanity, but his pain cuts through vanity in humans like a hot knife in butter. A deeply psychological series, yet humorous.
Pain issues are normally very unpalatable to the public. This show deserves some kind of award.
A recent show brought in what we choose to call the “Alan Hess principle” in honor of the author of the most read piece at painonline, Alan’s “Reality CP”. We use the term because in his article at this site, Alan makes clear that his pain is very much more disabling than the immobility from his motor impairment. For what it is worth, one hundred percent of those completing surveys agree with Alan. Pain gnaws away until it empties you out. Immobility is embarassing and inconvenient (we omit bowel and bladder problems from this calculus since they are more or less in the area of humiliation).
Dr. House has a handicapped parking stall because the neuropathic pain in his leg causes pain “WITH EVERY STEP”. His place is taken away and given to a rather charming researcher who is in a motorized wheelchair. House goes nuclear over the additional yardage he will have to walk. The hospital admin says wheelchair trumps cane. House confronts the girl in the wheelchair and wants his parking place back. She replies by saying “chair”. House counters with “cane”. Then he says all the additional distance means for her is to continue pushing on her lever a few seconds longer. He says sarcastically, “Those additional five seconds you have to push the lever must really kill you…I have serious pain with EVERY extra step”.
This really is the classic battle of disabilities. Which trumps which? Pain vs. wheelchair? The Alan Hess principle would say pain must be given first priority. The hospital administrator maintains that anyone in a wheelchair must have preference over someone who is in pain to walk. This sets up a contest which the oncologist calls “A sibling rivalry between disabilities”, which he says is unseemly. House refuses to give in, saying that logic clearly indicates that pain is worse to endure than a wheelchair and to prove it, he goes around in a wheelchair. He makes a big show about how little an inconvenience it is for him, even making his patients bend down to show that being down at the level of a chair is not so bad. It is very hilarious to see this fight. The problem is that in reality, it is serious. This is because not only do chairs get parking spaces, they get research dollars.
Get the point? Like it or not, somewhere along the line, we have to include BOTH in our caring. A whining helpless snarling person with pain will often have the impossible personality of House. And yet, reduced to logic, it is very much harder for someone to move with pain than to propel a motorized wheelchair. Although House is pooh-poohing the problem of chairs, he actually highlights it as he cannot figure out how to get his chair into his station wagon. He winds up accelerating to cause the car door to shut since he cannot get across to close the door.
In short, the directors do justice both to the predicament of pain and to the predicament of wheelchairs. This sounds not so special except that it has never been done before in the media. It has not even been considered, let alone well handled. These writers and producers are really something special. Due to the kinesthetic dysesthesia of central pain, well described by Alexsandre Beric in Muscle and Nerve, muscle pain can be so severe that the patient cannot move at all. This is a different sort of paralysis. Pain paralysis.
House has neuropathic pain from a gunshot wound to his upper leg and is “addicted” (actually he is merely dependent) to Vicodin. He is nevertheless portrayed as an intelligent person, rather than a crazed criminal, as federal regulators and prosecuting attornies seem to believe regarding those dependent on medicine for neuropathic pain. Juries always fall in line with the “drugs are bad, and we don’t care about pain” idea when this mythological witch hunt hits the courts.
That is why the legal high priests love to pontificate on the evils of taking legitimate pain meds, never once remembering to declaim on the much greater evils of allowing humans to wallow in unbearable pain. The moral self righteous can get nauseating. May they reap what they have sown and all get arthritis or something when they get a little older. If they reach the Supreme Court, they will be “weaK” and behave just like anyone else by taking pain meds, just as William Rehnquist took Placidyl for back pain. The drug affected Rehnquist to the point of causing odd behavior, yet his opinions show he was still a brilliant human being. He was more or less the legal equivalent of House. His family, being ashamed by all of it, are reported to view his doctor as malpracticing. Yeah, treating someone with pain is clearly inexcusable behavior for a doctor. We should have just let Rehnquist swim with the dolphins or stuffed him with placebos.
It all highlights the Alan Hess principle, which is, that Central Pain is much more disabling than the paralysis. It is the logical and inevitable conclusion of reflective reasoning, but not the initial reflex analysis. Our eyes play tricks on us. Who would have thought the producers of House would have picked up on this? The show just keeps getting better and better.
In coming weeks, we will learn if House gets his parking space back and how Cutty, the hospital administrator sorts it out. We LOVE this show.
