The Beautiful Hospital

In "House," impossibly gorgeous physicians miraculously diagnose rare diseases in every episode. Where I work as a nurse, in the Ordinary Hospital, sometimes there's not even a doctor in the house.

By Sallie Tisdale

Read more: Sallie Tisdale, TV, Hospitals, Doctors, Life

April 4, 2007 | Like a lot of people who work in healthcare -- I'm a nurse -- I started watching "House" because of the mysterious diseases involved. Everyone loves a rare disease. And I was perversely charmed by the title character's nastiness. House says the kind of things I sometimes want to say -- mostly, to doctors. (Dr. Weber: "I know I know you." House: "Sure you do, Dick." Weber: "The name's Phillip." House: "Oh, my bad. Something to do with your face. I always think your name is Dick.") I kept watching in spite of his flamingly litigious behavior: He calls one patient "Mrs. Nympho" and says of a Chinese woman, "Not the sharpest chopstick in the drawer, is she?" I watched for a whole season, in spite of knowing that the crude passes, Internet porn and Vicodin addiction meant that any doctor like him would be both bankrupt and imprisoned.

But I'm frustrated now. I call "House's" world the Beautiful Hospital. There are the wide, bright hallways, miles of floor-to-ceiling glass, and the many private, luxurious patient rooms (none of which appear to belong inside the hulking brick institution seen in the bird's-eye credits). Mostly it is a Beautiful Hospital because it is staffed almost entirely by a trio of gorgeous and impossibly brilliant physicians. No one else works at the Beautiful Hospital except a few secondary gorgeous and brilliant doctors and an ever-changing cast of extras whose only job is walking down the hallways in scrubs.

By my incomplete count, the three handsome doctors who work under House -- Cameron, Chase and Foreman -- all sadly lacking a sense of humor, are educated in the entire gamut of medical specialties, from brain surgery to dermatology to obstetrics. Their patients have diseases like adrenoleukodystrophy, cervical spondylosis and Miller-Fisher syndrome; a surprising number wind up getting experimental surgeries, organ transplants and drugs not on the FDA-approved list. (On "House," the correct diagnosis always follows a lot of wrong ones and the patient's near death at the hands of the brilliant diagnosticians.)

They are also trained as phlebotomists, bacteriologists, geneticists, nurses (all specialties), pharmacists, a three-person advanced cardiac life support team, CT technologists, radiologists, MRI technologists, hyperbaric chamber technicians, respiratory therapists, social workers, epidemiologists, substance abuse counselors, polysomnographic technologists, organ transplant coordinators, immunologists, chaplains, pathologists and private detectives. The last stems from their weekly unauthorized and wholly illegal forays into the garbage cans, dresser drawers and bathroom cabinets of their patients, a behavior I have never actually seen a doctor engage in before.

I'm surprised they don't fix the air conditioning as well, but I guess they have to delegate something.

Last week, I worked an evening shift at the hospital. I had four patients under my care in the oncology unit where I have worked for several years. One, struggling with a tumor in his liver, merely had the problems of pain control and nausea with which I am intimately familiar. Another was a woman in her 70s dying of kidney failure. (Many of the hospital's dying patients are transferred to our unit for their last days.) A man in his 40s had severe abdominal pain of unknown origin and was going through tests. An elderly man was slowly recovering from the severe side effects of the treatment of his renal cell cancer.

Ours is not a Beautiful Hospital. We can call it the Ordinary Hospital, at least in accommodations. Two of the patients shared a room, which meant sharing the sounds and smells of vomiting and pain. There are no walls of glass here. The rooms are small and rather cramped, and the thermostats don't work all that well. My pager tends to go off at awkward moments. There are no private offices for conferences with family members, who sometimes weep in the hallways. We are short on impossibly good-looking and inhumanly skilled diagnosticians.

I was helping the man with the liver tumor to vomit when one of the respiratory therapists came in and told me the man with renal cancer had a fast, irregular heartbeat. I looked him over and then called the doctor, who that night was in fact a nurse practitioner. Another nurse looked up his records for me. We decided to watch him closely, and when his heart was still flailing away a half-hour later, I ordered an EKG, which was done by the same respiratory therapist who'd first noticed the problem. More phone calls, more consultation, and then I had new medication orders for the pharmacist and a long report for the next nurse.

Several of us were involved. None were doctors.

I compare "House" to "ER," another drama I used to watch regularly. "ER" is the Ugly Hospital. There are actually nurses working there, as well as orderlies, secretaries and janitors. Some of the staff are even obese and bald and pockmarked, just like the rest of us. There is a high rate of drug abuse and suicide attempts among the staff, perhaps due to the epidemic of promiscuous partner-swapping. (The staff on "ER" have always had a disturbing tendency to be distracted by their sex lives during livesaving procedures -- "Lidocaine, stat! And where did you get that hickey?")

I was fond of the helicopter-blade amputation; I liked Kerry's malleable limp, and George Clooney can get excited about my kid's cold anytime. But I got tired of the whining ("I can't believe you kissed her! Lidocaine, stat!") and the ceaseless parade of crazy, violent, manic, weeping, infectious, tragic and critically ill people coming through the doors. Most emergency rooms don't have quite the same traffic. Over time the janitors and secretaries have faded out and a lot of the nurses seem to have quit, and the ones left have gotten suspiciously thin and blond. And even though it is definitely the Ugly Hospital, none of the doctors is obese or pockmarked.

I fondly remember "St. Elsewhere," one of the first television shows I ever watched regularly. It was inevitably focused on the doctors, but they were ordinary-looking people, not very charming and definitely not brilliant, and they tended to freak out if the nurses weren't there to save their asses half the time. Some of the nurses were really bitchy, too, and a few were downright brilliant.

Too bad it all turned out to be a dream.

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