On House

The Little Doctor Who Wasn't Really There

By Bradley H. Sinor

I didn’t start watching House M.D. when it first came on the air, mainly because my initial reaction was, “Oh no, not another doctor show.” When I did start watching the series, I found out how mistaken I was. That first episode I saw, maybe the sixth or seventh of the season, turned out to have a sharp story, interesting characters, and, to say the least, some very cool special effects.

Almost from that first view I also noticed something odd about one of the characters, or at least I thought it was odd. That person was James Evan Wilson, M.D., graduate of Montreal’s McGill University. Besides being the head of the Princeton-Plainsboro Teaching Hospital’s Department of Oncology, he also happened to be Dr. Gregory House’s best and, perhaps, only friend.

The thing that struck me as odd about Wilson, almost from the very first episode, was that, at times, I found myself wondering if he was real. Yes, he was on screen, but there was something almost supernatural about him.

In several instances House turned around or looked up and Wilson was just standing there. There was no sign that he had walked in–i.e., the sound of a door opening or someone saying “Hello”–or any indication to show that Wilson had been in the room all along. At first it only seemed to happen when no one else was around. Then I noticed that there were times when others were in the room and didn’t seem to notice him.

In “Occam’s Razor” (1-3), when Foreman came into House’s office with the results of a test on a lacrosse player, Wilson was sitting right there in front of House’s desk. The two of them had obviously been talking, yet Foreman never acknowledged Wilson’s presence in any way, manner, or form. You would think that a younger doctor would at least acknowledge the presence of a senior doctor, especially one who happens to head up an important department at the hospital, if only as a matter of protocol and job courtesy. (Though of course, in all fairness, Wilson also didn’t turn around and look at Foreman, the normal reaction when someone walks into a room.)

In the opening sequence of “Damned If You Do” (1-5), something similar happened with Dr. Cuddy: Wilson and House were talking about a patient when Dr. Cuddy came into the room. She talked only to House and seemed to look right through Wilson.

We can come up with reasonable explanations for instances like these. Usually, it takes something urgent to convince someone to interrupt House when he’s in the middle of something, and there isn’t a lot of time for common courtesy when someone’s dying. But times like these aren’t the only ones in which others have failed to acknowledge Wilson’s presence.

And sure, hospital employees might not speak to Wilson when House is around, unless it is on hospital business, because they don’t want to have a run-in with House. (After being on staff at the hospital for eight years, House is no doubt known and feared by a lot of the people who work in the building, be they doctors, nurses, or support personnel. While it is unlikely that a new employee’s orientation would include a warning about dealing with House, you can bet that within a few days veteran members of the staff would have passed on warnings to not cross paths with him.) But it isn’t just the hospital staff that seems to ignore Wilson’s presence. In “Damned If You Do,” the patient’s sister approached House and Wilson but spoke only to House, never once even looking at Wilson. During “Paternity” (1-2), House and Wilson were sitting outside on the patio having lunch. The parents of House’s teenage patient approached him and want to know what the prognosis was for their son. Like Foreman, they talked only to House and never reacted, even with a nod, to the fact that there was another person sitting at the table with him.

“Maybe he’s the little doctor who wasn’t really there,” my wife suggested when I mentioned my observations to her.

Given the evidence, even Sherlock Holmes would have had to consider the possibility: Wilson was House’s imaginary friend.

Having imaginary friends isn’t exactly unique, though having one when you’re over the age of eight is a little more rare. (Then again, this wouldn’t be the only way in which House could be said to act like a child.) Children often create imaginary friendships as a “practice ground” for real friendships . . . and boy, does House need practice. The reason it’s such a good way to practice at relationships is that the child has control over the interaction, something that would be impossible with a real person. House does enjoy being in control.

Imaginary friends also act, often, as a source of companionship for a child, something House certainly lacks (and may want more than he lets on), but they also often embody personality traits that their creator lacks–they are the ideal version of the child himself. It’s hard to imagine House wanting to be Wilson–but isn’t it possible that he would sometimes wish that he were more kind or compassionate (or at least have more dates)?

An imaginary friend can also act as a confidant, someone with whom a child can share their secrets and problems. Wilson certainly acts in this capacity for House. And while Wilson might not give House the confirmation that his ideas about a particular case are right, he will often point out something that gets House moving in the right direction. In “Damned If You Do” (1-5), Wilson made a joke that the ailing nun might be allergic to God, causing House to order a full body scan on the theory that there was something physical inside of her causing her allergic reactions. During “Hunting” (2-7), it was a discussion with Wilson over the patient’s sweating that caused House to realize that the illness could have been caused by an unsuspected parasite.

House wouldn’t be the first fictional character to have an imaginary friend. One of the classic cases is Elwood P. Dowd, in the stage play and movie Harvey, whose best friend was a six-foot-tall invisible rabbit (named, appropriately, Harvey). More recently, the long-running comic strip Calvin and Hobbes featured the adventures of six-year-old Calvin and his best friend, the stuffed tiger Hobbes, who could only be seen as alive and heard by Calvin.

On television, imaginary friends have been turning up in a variety of shows. M*A*S*H had an episode featuring Hawkeye Pierce’s childhood imaginary friend, Captain Tuttle (“Hey, when I got drafted, so did he” [“Tuttle”]). More recently, Hurley on Lost was shown to have an imaginary friend named Dave (“Dave”).

Wilson, though, is real; there is absolutely no doubt about that fact. There are any number of people in the House-verse who can testify to his reality: the hospital administrator, Dr. Lisa Cuddy; the other members of Team House; Debby in Accounting; Detective Michael Tritter; and Grace, the patient Wilson moved in with, as detailed in “House vs. God” (2-19), after discovering that she was dying and alone.

But suppose he isn’t real all of the time.

In other words, what if what we had were two Wilsons, one real, the other a product of House’s imagination?

It’s a compelling theory.

But House is a medical show, and so we should consider a medical explanation for the phenomenon. So let’s do a differential diagnosis on House. Why might he be seeing someone who isn’t really there?

One possible culprit might be schizophrenia; its symptoms include delusions and auditory hallucinations. That would explain House’s ability to both see and hear Wilson. But usually a schizophrenic hears voices that torment and berate not only him, but the people around him–and Wilson tends to save his berating for House alone. (House, on the other hand. . . .) Also, the lack of concentration and physical unsteadiness of the schizophrenic mother from “The Socratic Method” (1-6) are pretty classic for schizophrenia, and they don’t sound like House at all.

Having hallucinations of his best friend could be the result of drugs. The only drug that we see House take is Vicodin, for his chronic pain, and he does use a lot of it–he gobbles pills like they were M&Ms in some episodes. According to a number of medical Web sites, the recommended dosage for Vicodin is no more than five tablets in a twenty-four-hour period, accompanied by six to eight full glasses of water. When the police searched his apartment in season three, House was found to be in possession of over 600 tablets–and we see how often he needs a refill.

The problem with our drug hypothesis is that the side effects of Vicodin include euphoria, seizures, and dizziness (among others)–but not hallucinations. So that eliminates drugs as a possible explanation.

But if House’s “hallucinations” aren’t the result of mental illness or an overdose of drugs, what can we possibly be dealing with?

How about reality, of a sort?

House is a bit more than a “simple country doctor,” as Wilson facetiously described him in the pilot. If he did begin to actively hallucinate, seeing Wilson in places his friend wasn’t, House would more than likely realize he had a problem.

So what options would he have? He might go to another doctor at a different hospital, since his ego would not allow him to admit to his coworkers that he had a problem. Then again, he might present it to his own team, changing the name of the patient. House has no problem with conjuring up a good fantasy; witness his substitution of Carmen Electra in the episode “Three Stories” (1-21) to “disguise the identity of the patient. I got tired of using the middle-aged man, so Carmen seemed like a pleasant alternative.”

Since he hasn’t done either of those things, House must be aware that he sometimes talks to someone who isn’t really there, and not have a problem with it.

In “No Reason” (2-24) after he was shot, House’s subconscious conjured up a whole scenario with not just Wilson but the entire hospital staff, not to mention his assailant Moriarty, in order to figure out what he needed to alleviate the constant pain in his leg.

So, obviously, House is aware that the fantasy Wilson is nothing more than a projection of his subconscious, not an illness of any kind. Since he has done nothing to try to cure himself, House must recognize that his imaginary friend is actually his own mind speaking to him, in order to give him the push he needs to solve the mysteries in front of him.

It also, no doubt, pleases House’s ego to no end, knowing that even though it might wear Wilson’s face, he is in the end talking to the smartest person he knows: himself.

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