Changing how the world thinks about nursing

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Cat People

A cat has absolute emotional honesty:   human beings, for one reason or another, may hide their feelings, but a cat does not.

Ernest Hemingway            

March 16, 2009 -- The main patient in tonight's episode of Fox's House was a nurse who believed that a cat tended to sit with those who were about to die--including, recently, the nurse herself. That may not sound like a promising vehicle for House to improve its abysmal portrayal of nursing. But the show actually presents the nurse as someone with health knowledge. And her search for meaning in faith, for some reason in tragic events, is a real counterpoint to House's cold rationality. Indeed, despite the obvious potential for mockery in the cat angle, the mighty House treats the nurse with considerable respect--he seems to care what she thinks, or at least to find her views unnerving. Of course, the nurse plays no real clinical role in the episode, and no other nurses do either. So the episode suggests, as usual, that physicians provide all important care in hospital settings, including all meaningful psychosocial and physical care. Still, any suggestion that intelligent life resides in a nurse is a welcome departure for House (and for the episode's writer Peter Blake, who also penned a November 2005 House episode that was notable for its physician glorification and its casual contempt for other health professions). Tonight's episode, "Here Kitty," drew 13.1 million U.S. viewers.

Click here to watch the Quicktime film clips in broadband or dialup. (11 min)

Click here to send our instant letter (or one of your own) to House!

Tonight's nurse character, Morgan, seeks House out in his clinic role. She says she fears she is going to die, complaining of colds and being run down and actually suggesting specific blood tests he might run (a nurse! with a brain!). At first House is not intrigued by Morgan's problems--which is the threshold requirement for becoming his patient--and it probably does not help that the nurse presents in a somewhat apologetic, pleading way. But when Morgan collapses and mysteriously pees green on herself, House and his team begin one of their diagnostic investigations. There seems to be nothing seriously wrong with her, and it looks like she will need to leave the hospital. Then she reveals that she is convinced she will die because the cat has singled her out. She points out that others at her nursing home (even physicians!) agree that the cat seems to have some supernatural power to predict death, and that the animal has even attracted news coverage to that effect. But when even House loses interest, Morgan fakes a seizure. Even in this context, she displays some health knowledge by denying Münchausen syndrome before House can even suggest it. She collapses and the physician Kutner diagnoses bronchospasm, which is hard to fake.

Eventually, House becomes convinced that there really is something serious wrong with Morgan. But "dean of medicine" Cuddy is not convinced, and she has Morgan discharged. So House induces symptoms--by persistently blowing cigar smoke in the nurse's face as she is being released outside the hospital--so she can remain an inpatient.

At the same time, House seems almost obsessed with persuading Morgan that there is no purpose to the bad things that happen to people. That is, no supernatural force is telling the cat who will die as part of some grand plan, just as there was no larger purpose why Morgan's stepson choked to death at his school some years ago, an event the show suggests broke up her marriage and which appears to haunt her to this day. Morgan tells House the teacher did everything she was supposed to do, but the child died anyway. (No, the show does not seem to wonder why there was no school nurse around.) Anyway, Morgan not only argues that there must be some reason for such events, but she also seems to suggest that belief is a kind of good in itself, because otherwise, why would life be worth living? What kind of world would it be with nothing but House's science and reason to help us confront tragedy and hardship?

You might think this would lead to relentless mockery by House, but in the back and forth about whether there is any cosmic design for sad events, House takes Morgan's positions seriously. And he treats her with what can only be called respect, though of course he's not exactly sensitive about it (he describes her stepson's death as "meaningless"). House actually mounts an argument about the absurdity of blind faith. He tells her:

In 1844, a preacher in upstate New York added up some dates in the Bible, and predicted Jesus's return. His followers gave away all their possessions and showed up in a field. Guess who didn't show. So the preacher said he miscalculated and he went right back the next month. But with more followers. Every time he was irrefutably proved wrong he doubled everyone's belief.

Perhaps part of the reason for House's conduct here is that Morgan is relatively unassertive and is no obvious authority figure; maybe her honest vulnerability disarms him. He spends much of the episode trying to show her she is wrong. That means he actually cares what she thinks, which is perhaps the highest compliment House can pay, and something we don't recall ever happening with a nurse character since the show began in 2004.

In the cigar scene, House notes that he has checked, and Morgan went to a "good college, good nursing school," so she was not always a "superstitious idiot." That might sound like an insult to the uninitiated, and of course, some viewers might wonder if "nursing school" was somehow distinct from "college." But House's comments could be interpreted this way:   "I know that some nursing schools are better than others because it actually is a serious health profession, and you went to one of the good ones--so what happened to you?" This may be the best thing House has said about nurses in five years.

Of course, Morgan does not really play much of a role in the House team's diagnostic adventures, except to experience symptoms. And neither she nor any other nurse provides clinical care, so as usual, all meaningful care in the episode is given by the many physician characters who dominate the show.

The episode is also consistent with the show's seeming reluctance to introduce a significant nurse character in a clinical setting (to say nothing of a recurring nurse character). Of the two nurse characters who have arguably been most prominent on the show, neither has really been shown practicing in a clinical setting. The other nurse character, who appeared in an April 2008 episode, was married to the episode's main patient; she did save her husband's life by performing CPR, but the show never showed her practicing in a clinical setting. It's as if the show wants to try to do something to rectify its poor portrayal of nursing, now and then, but feels that having a practicing nurse interact with the House team or patients or provide technical care--doing what nurses really do--would threaten the show's physician-centric fantasy world.

In the end, House figures out that the cat's behavior was simply a result of it seeking out physical warmth--from patients with fevers, or those "wasting" away who had had heating blankets put on them. And Morgan was warm because she has cancer, specifically cancer of the appendix. Apparently the cancer is treatable, though the show does not seem to care much (which is not surprising, since it is solving the medical mystery that really matters). House confronts Morgan with all this. He argues that he has proved her beliefs wrong by using science and reason to save her from the cancer, and from the dangerous, more aggressive surgical treatment for her Cushing's disease, which she might have pursued when she thought the cat was predicting the Cushing's was going to kill her.

But astonishingly, the nurse does not back down. Instead, she argues (correctly) that House only figured all this out because the cat came and sat on his laptop computer, showing its desire for warmth. Morgan suggests that the cat's action itself revealed some greater force. This is a clever bit of jujitsu, turning House's "science" into a startling coincidence that may itself reveal the influence of a higher power. It's easy to simply claim positive scientific or other events are guided by God, but Morgan is focusing on the unlikelihood of the event giving rise to House's epiphany. She goes on:

Morgan:  I looked up the preacher from New York state. His followers never faded out. They became the Seventh Day Adventists. A major religion. That man changed the course of history.

House:  Because his followers were as deluded as he was.

Morgan:  Maybe he just gave them something to live for.

House calls her an idiot again, but when he says goodbye with a grim "feel better," it sounds like he means it.

The show deserves credit for making an effort to show that nurses are not necessarily "idiots," and for having House himself treat one with an unusual degree of respect, suggesting that her perspective on life has actually made the great man pause. But if the show really wanted to embrace its hero's fearless commitment to "science," it would introduce a character from a "good college, good nursing school" to go head-to-head with him every week--and give us something to believe in.

Click here to watch the Quicktime film clips in broadband or dialup. (11 min)

Click here to send our instant letter (or one of your own) to House!

 

 

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