“Autopsy” – Season 2, Episode 2 House MD Goodness and the Demand to Change Your Life

 

Summary

Nine-year-old Andie, in remission from cancer, presents with hallucinations. The team discovers a blood clot in her brain but cannot locate it precisely. Because she has only a year to live, the decision to attempt an extremely dangerous procedure rests, in part, on her willingness to undergo it.  

   At first, as per usual for House, the puzzle is purely medical. He’s a medical Sherlock Holmes. But when Andie calmly accepts her prognosis and focuses on giving her mother one more year of life, House is provoked. He treats her serenity and courage not as evidence of character but as a potential neurological symptom – an anomaly to be explained away. The drama of the episode is to find out whether her serenity and courage are real, with House’s rejection of the attitude towards a soul at stake, i.e., the fundamental way of regarding and responding to a human being not merely as a physical object or mechanism, but as a person whose inner life is directly expressed in gesture, speech, suffering, love, and action.

 

     House frames her courage as biologically suspect:

 

House: “Cancer kids; you can’t put them all on a pedestal.”

 

House: What if her bravery is a symptom? The clot is causing hallucinations and messing with her emotions.

 

Foreman: You think her bravery is chemically based.

 

House: Would tell us where to look for the clot. Where’s the fears center?

 

He refuses to allow bravery, love, or nobility as real. They must be reduced to brain function or chance statistical distribution. Not to share his cynicism means sentimentality or wishful thinking, which House meets with sarcasm and scorn:

 

Wilson: Andie handles an impossible situation with grace. That’s not to be admired?

 

House: You see grace because you wanna to see grace.

 

Wilson: You don’t see grace because you won’t go anywhere near her.

 

House: Idolizing is pathological with you people. You see things to admire where there’s nothing.

 

Wilson: Yeah, well, we’re evil.

 

He seems indifferent to the girl’s suffering or impending death. He wants to be there when she breaks down, I suppose to tell Wilson “I told you so!”

 

House: Well the clots not gonna to go away quietly. It could blow at anytime. Are you gonna let them know?

 

Wilson: I guess so.

 

House; Can I come with?

 

Wilson: To tell Andie she’s going to die? That’s very un-you.

 

House: She’s such a brave girl. I want to see how brave she is when you tell her she’s gonna die.

 

Wilson: Go to hell.

 

Faced with doing a radical procedure on Andie, in which she will technically be dead for some time while part of her blood is removed so that the doctors can look for a clot in the brain, House starts to doubt himself. Wilson has just given him the consent forms signed by Andie’s mother:

 

House: What did Andie say?

 

Wilson: About what?

 

House: About this?

 

Wilson: I didn't talk to her. She doesn't need to know the specifics of this procedure.

 

House: What if you're right about her? What if she just is that brave?

 

Wilson: That doesn't mean she's mature enough to handle this kind of decision.

 

House: Either she understands, or she's not brave. You can't have it both ways. If she does understand, then she deserves to know what's going on.

 

So, premised on his doubting his own reductionism, he seeks her out to tell her the full risks, in part to test whether she really knows what she’s doing – a sign of respect, a move into the attitude towards a soul, revealing another side of House that doesn’t neatly fit into his reductionism or scientism. When he confronts Andie with her options, he is brutally honest but respectful, more respectful perhaps than the caring doctors.  

       I want to pause to reflect on this scene in a bit more depth. Keeping Wittgenstein’s attitude towards a soul in mind, House has reached a state of mind (drug-influenced?) where his default tuning – to see human actions as reducible to causal determinants – is being disrupted. By what? By the fear of demeaning and then violating something precious, the girl herself. It’s not that he abandons his reductionism entirely; it’s that he temporarily allows another attitude, another tuning, to become operative and trouble his certainty. Most of the time, House lives as if the inner life of a human being is nothing more than brain chemistry, stimulus-response patterns, and evolutionary programming. But his reductionism is also a defense mechanism; it shields him from being personally bound by the moral realities that show themselves if people are acknowledged to be more than their causal determinants. Perhaps he feels he must remain in this state to be the genius he is, that he would no longer be special if he lived in a world in which others were real? (Other people are not fully real to House most of the time.)

       In this scene, the possibility that Andie is “really that brave” forces a shift. If she’s genuinely brave – not just chemically induced to appear brave – then she is a soul, an embodied soul. And if she is an embodied soul, then he owes her the truth as she has the right to make her own choice. That’s why he pushes past Wilson’s paternalism: Either she understands, or she’s not brave. But he also implicitly gives up his absolute reductionism in so doing. In this moment, House is acting “as if” the inner life (the soul) is real. His motivation is partly diagnostic (testing whether her bravery is genuine), but partly ethical: you can hear in his voice that he doesn’t want to be patronizing. This is already a move into Wittgenstein’s “attitude toward a soul,” seeing the girl as a soul and not as an automaton. The writers use moments like this to show that House’s reductionism is not seamless; cracks appear when confronted by undeniable dignity or moral beauty. In “Autopsy,” that crack opens because the stakes are existential as he’s not just treating a body, but possibly overriding a young girl’s final, meaningful choice. This possibility cracks his default reductionism.  

 

   And then the scene where House lays it on the line to Andie:

 

House: Tomorrow’s test could take ten hours, in your present condition you might not even make it through.

 

Andie: My mom’s done a lot of research.

 

House: How do you feel about it? If we figured maturity came from how much time you’ve got left instead how long you’ve been here, this would be your call.

 

Andie: I don’t have a choice right?

 

House: I could give you one.

 

Andie: I wanna get better.

 

House: You’ve got cancer. I fix this…

 

Andie: I’ve got a year.

 

House: A year of this. A lot of people wouldn’t want that. A lot of people would just want it to be over.

 

Andie: Are you asking if I want to die?

 

House: Nobody wants to die. But you’re going to. The question is how, how much you’re gonna suffer and how long. I’m asking if you want this to be over.

 

Here, when it matters for House as well as his patient, an act has moral weight only if it’s the result of free, informed choice, not biological determinism or social expectation. This choice is perhaps only possible in House’s thinking in extreme situations of life and death. House sees others’ admiration of her grace and courage as sentimental. Wilson wants to see grace because he needs to believe in it, and so he idealizes and falsifies the girl to produce that self-gratifying feeling in himself – that is what House believes anyway. Then comes the sublime moment of revelation:

 

Andie: What would you tell my mom?

 

House: I could give her ten excellent medical reasons why we can’t do this procedure.

 

Andie: I can’t just leave her cause I’m tired.

 

House: But you can’t stay for her either.

 

Andie: But she needs me here.

 

House: This is your life, You can’t do this just for her.

 

Andie: I love her.

 

She acts out of love. House has nothing else to say. Q.E.D. It is a real choice and it comes from a place of love, of deep meaning that cannot be demeaned by reducing it to something that is non-meaning, non-love, mechanical. I think it is one of the two most moving scenes in the series. The wonderful thing about House is that his very cynicism removes the possibility of sentimentalizing what happens. Her love breaks through the cracks in his armor.

 

    The last scene I want to focus on is when Andie is discharged from the hospital. After the surgery and treatment decisions are behind her, Andie is preparing to leave the hospital. She moves through the lobby or corridor, saying goodbye to the people who have been part of her care. She’s dressed in street clothes now, a small figure among the adults, carrying the quiet composure that has marked her through the episode. She hugs Cuddy, Cameron, Foreman, and Wilson warmly, each of them responding with affection and a touch of sadness. When she reaches Chase, he gives her tickets to the American Museum of Natural History, telling her, “In case you want to see real butterflies.” She smiles, hugs him, and kisses him lightly on the cheek – a simple but meaningful gesture. Then she comes to House. He deflects in his usual way: “I’m not gonna kiss you no matter what you say.” Instead of words, she just steps forward and hugs him. It’s brief, but she holds on for a moment – and House, notably, doesn’t push her away. There’s a flicker of surprise, even softness, in his face. As she steps back, she says: “It’s sunny outside, you should go for a walk.” House glances down at his cane and replies with wry understatement: “Not much for long walks in the park. Now get.” She leaves, still smiling, heading out into the sunlight. House watches her go. The camera lingers just enough to suggest that the moment has touched him, though he won’t admit it. After Andie is gone, Wilson later tells him the clot was nowhere near the amygdala – her emotional center was intact. Andie’s courage was real, uncaused by neurological damage. House says simply, “Yeah,” when told this, dropping sarcasm for a moment. Immediately reverts to irony (“I’m beside myself with joy”) and deflects into demeaning banter.  

 

Wilson: Yeah. So her bravery was not a symptom.

 

House: Yeah. I was wrong; she genuinely is a self-sacrificing saint whose life will bring her nothing but pain, which she will stoically withstand just so that her mom doesn’t have to cry quite so soon. I’m beside myself with joy. [He does a line] Whoa!

 

Wilson: She enjoys life more than you do.

 

He sees the goodness but refuses to allow it to demand change in himself. Or does he? He goes out and buys a motorcycle. Hope for House?  

 

   I am puzzled how – philosophically – House can recognize Andie’s goodness, admit his reductionism (and cynicism) doesn’t apply to her, and not change his life. There are good psychological reasons for this:  

 

•        He protects himself from having to deal with the reality of people, making himself invulnerable emotionally and morally (Nietzsche’s Übermensch, super-man beyond good and evil), moving any moral responsibility from his actions.

•        It gives him the illusion of total mastery, the world explained, tamed, flattened into categories one can grasp. “If I can explain everything in terms of particles and evolution, I don't have to admit ignorance or mystery.”

•        It protects him from having to face life’s deepest questions of meaning, suffering, love, death, and judgment by explaining them away. “If everything is biology, I don’t have to wrestle with why I exist or what my suffering means.”

•        House is an anarchist who resents all moral or religious authority. Reductionism undermines any claim to speak with objective, binding truth, to speak to the conscience (as Wilson often tries to do). “If morality is just a trick of the brain, then no one, not a priest, parent, or philosopher, can tell me how to live. I can be completely autonomous.”

•        House is hostile to religion, as I will discuss in the episode “One Day, One Room. Reductionism as a shield against transcendence. If everything can be explained in natural terms, then there is no room for God, judgment, grace, or the soul. “If I admit that love, goodness, or beauty point beyond biology, I may also have to admit that I am not my own god.” (I am often astounded at the high philosophical price people  are willing to pay to keep God out of their belief system.)

 

That if reductionism were true, however, there would be no self to protect, and so all of these psychological incentives to embrace reductionism are (prima facie) philosophically absurd even if they make psychological sense. Which brings me back to the question: How can House acknowledge Andie’s reality and yet not change his life? How, philosophically, can he escape absurdity? Here are some possible answers, none of which are intellectually satisfying:

 

•        House could keep his reductionism by treating Andie as a rare exception that doesn’t threaten the general rule. Her goodness is real but rare, a product of extreme, borderline circumstances (terminal illness, extraordinary temperament). Thus his worldview remains intact: most human goodness is illusory, and the exceptions are so rare they don’t require rethinking the basic attitude. Philosophically, this is a version of what Thomas Kuhn called protecting the paradigm: anomalies are noted but not allowed to overturn the default paradigm.

 

•        House could compartmentalize the experience. One can adopt different “attitudes” in different contexts, which Wittgenstein might describe as moving between language games. In a medical-ethical context, House can act as if personhood, dignity, and moral choice are real because the practical demands of that “game” require it. In his reflective or private life, he can revert to his reductionist “tuning” toward human beings. From inside this stance, it’s not seen as a contradiction, but as contextual reasoning.

 

•        I don’t think this applies to this episode, but House might act on moral realities without granting them full reality – a kind of moral fictionalism: “I don’t believe in capital-G Goodness, but in situations like this it’s useful or even necessary to act as though it exists.” Philosophically, this is consistent if you believe moral language is a useful fiction but it avoids existential consequences because you never affirm the reality behind the fiction. But House acknowledges the reality of Andie’s goodness.  

 

•        House could reinterpret Andie’s goodness in language compatible with his reductionism: Her bravery is real as an observed phenomenon, but it’s still “explained” entirely by causal determinants such as genetic temperament, upbringing, neurological wiring. The meaning of her goodness is denied; what remains is a description of behavior that can be subsumed under a deterministic model. This preserves philosophical consistency by redefining “goodness” in terms that strip it of metaphysical or moral depth. But House doesn’t do this either. He acknowledges the reality of Andie’s goodness.  

 

Evidence of love and self-sacrifice confronts him, he is moved by it, but he bets his life on cynicism anyway. “Goodness is real, if rare; but I choose to ignore it when it comes to my life.” I can’t make complete sense of it. It is hard not to conclude that House is irrational. Reason is the mind in harmony with reality, and House’s is not, as the show portrays it.  

 

“Lines in the Sand” – Season 3, Episode 4 Reductionism Reveals a Soul

 

Summary

In this episode, a 10-year-old nonverbal autistic boy named Adam suffers a mysterious medical collapse during a meltdown at home. Brought to Princeton-Plainsboro, his condition baffles House and the diagnostic team. Because Adam cannot speak or describe his symptoms, the doctors must interpret his behavior to uncover the underlying illness.

      House is drawn to the case, both intrigued by the diagnostic challenge and oddly connected to Adam’s insistence on routine and silence. While treating Adam, House expresses skepticism about whether the boy is self-aware or simply mimicking learned behavior. He even suggests that Adam’s life may lack meaning due to his inability to communicate or connect.

    Despite these views, House pushes for an unorthodox treatment for a rare intestinal issue, which leads to Adam’s improvement. In a quiet and emotionally powerful moment, Adam responds by offering House his handheld video game, a simple gesture that affirms his awareness and gratitude, and challenges House’s assumptions about his inner life.

 

 . . .

 

       The title “Lines in the Sand” is rich in meaning. Sand suggests silence, desert, dryness, evoking Adam’s mute world. Lines are attempts to communicate, to order or mark meaning, but sand resists permanence. A line in the sand, moreover, is not permanent; it can be swept away. The title also suggests boundaries between worlds, or dividing lines between people, between kinds of life. Adam lives in a world others can't enter: nonverbal, inward, neurologically different. The doctors and even his parents live on the other side of that line. More disturbingly, House verbalizes a thought that haunts the comportment of every other character toward Adam, questioning whether he is “really there,” as in living across a line separating persons from non-persons. This suggests that the line between “normal” and “abnormal,” “person” and “non-person,” may not be as fixed. Indeed, within House himself this competing concern has some purchase as reflected in the very decision to take the case.

Adam’s final gesture – the giving of the game – erases that line. It reveals shared humanity.          The title also connotes moral ultimatums: “drawing a line in the sand” as a firm stance. House draws that line: if someone isn’t self-aware, their life may not be meaningful. The episode challenges this stance, suggesting that true personhood exceeds such rigid criteria. It asks: Where do you draw the line? Who gets to draw it?  

      Finally, a line in the sand is exposed, meaning that it can be stepped over, erased, or ignored. (House does that constantly.) Human dignity, when people want to base it on our

capacities (e.g., intellectual capacity, verbal fluency, etc.), is similarly fragile. The episode calls into question the common notion that dignity is based on capacities and standards of normality, which, when absent, may mask the humanity of a human being.  

 

    My thesis:  Adam’s humanity is something the admirable hospital carers and even his loving parents are not able to see. Ironically, it is revealed through House’s response to Adam’s unexpected (sublime) gesture of gratitude to House for saving his life at the end of the episode.  House’s negative mirror shows what others are blind to despite their best efforts and intentions.

 

    Why does House decide to take Adam’s case? The other doctors are surprised that House insists on taking Adam’s case, and that surprise is an important clue to the episode. Because Adam is autistic and nonverbal, the team assumed they were dealing with a behavioral issue, part of Adam's autism, rather than a separate medical problem. Foreman believes this case falls outside the scope of their department: “it’s not a real case.” Chase and Cameron are sceptical because diagnosis depends on communication, and Adam can’t describe symptoms. House is also known for being clinical and detached, favoring interesting puzzles with solvable outcomes. A nonverbal autistic child doesn’t seem like the kind of puzzle House would enjoy, especially if the problem is presumed behavioral. So an explanation is called for.

     House may see himself in Adam: both are isolated, misunderstood, locked inside pain they cannot or will not express. Adam’s insistence on sameness and his distress at small disruptions echo House’s own compulsions and resistance to change (e.g., the carpet subplot). And there is a real puzzle here, albeit of a different kind. The fact that no one else can get inside Adam’s experience may make it irresistible to House, not so much out of empathy but of fascination with a brain even more different than his own. But I feel the most likely reason of all was philosophical. For all his cynicism, or perhaps because of it and the misery it entails, House is involuntarily drawn to potential sources of meaning, to what calls his cynicism into question and thus offers hope. Even as some atheists are compulsively drawn into debate with people of faith. Adam’s silence poses a kind of existential question: Is this a life worth diagnosing? If so, what does that entail for my reductive view of the world?

 

    The gulf between the parents’ world and Adam’s at the beginning already underscores a radical gap. We see the parents sacrificing apparently to no purpose, or their belief that their actions can help Adam to become more ‘normal’ and thus live a life worthy of a human being (as they and everyone else in the episode understand it) is illusory.  

   Then this exchange between House and Foreman, with Foreman making the case against devoting time to Adam:

 

Foreman: I had a date last night, she screamed. Should we spend a 100,000 dollars testing her?  

 

House: Of course not, this isn't a veterinary hospital. Zing! [He pushes the door open into the clinic.] Look, if you don't think this kid is worth saving –  

 

Foreman: That's not what I'm saying!  

 

House: Well, that's too bad, it's a good point. Kid's just a lump with tonsils. You know what it's going to be like trying to put an autistic kid into a nuclear scanner? I don't envy you guys.

 

Foreman is making a dark joke to express scepticism about Adam’s case being worth the trouble. “She screamed – should we spend $100,000 testing her?” trivializes Adam’s suffering by implying screaming is too nonspecific or common a symptom to merit medical inquiry. House immediately one-ups the sarcasm: “This isn’t a veterinary hospital. Zing!” The veterinary hospital allusion broaches the disturbing hypothesis that Adam (Man) is more animal than human. Animals can't talk, so veterinarians treat them based only on behavioral clues and physical symptoms. By analogy, Adam – a nonverbal autistic child – is being treated as if he’s less than fully human, or like an animal, because he can’t articulate his experience. This leads into the philosophical subtext: What Makes a Life “Worth Saving”? House’s implicit question is meant seriously, almost like he is setting it up as a hypothesis even as he is criticizing Foreman for entertaining it: “Well, that's too bad, it's a good point. Kid's just a lump with tonsils.” He voices exactly the dehumanizing attitude he’s trying to expose in Foreman, that Adam, because he’s nonverbal and autistic, is just a body, not a person. Taking the case is partly motivated by an attempt to answer this question, I think.

    We know of House’s rigidly dogmatic reductionist-scientistic attitude to life from multiple other episodes – which doesn’t prevent him on occasion from living as though the meanings he denies reality to were real after all. When Adam is supposed to have an MRI, he freaks out. House, who doesn’t believe he has an inner life, mimics what he should do. This, from Adam’s perspective, was actual communication, as Adam’s parents also recognized. They understood the trust it implied. For House, however,  it just confirms his ‘no inner life’ hypothesis: “monkey see, monkey do.” House speculates that Adam’s actions are merely imitation without understanding. This frames Adam’s behavior as reflex, not choice, a neurological loop rather than the expression of a soul. Philosophically, this aligns with a radical behaviorist model (e.g., B. F. Skinner), where observable stimulus-response patterns replace self-consciousness.  Thus House sees Adam as a body executing programs, not a person engaging in meaning-making: a dehumanizing gaze. The connection between reductionism and cynicism is on full display here. Without self-consciousness, the moral reality of Adam’s life is diminished.  

       If Adam’s life consisted only of unreflective responses, there would be nothing tragic about his death. On the contrary, it would reduce his suffering and liberate his parents to live again. This is a well-known view in philosophy (e.g., Peter Singer’s arguments on severe cognitive disability), namely, that the value of life is determined by subjective awareness and capacity for certain pleasures and relationships. House doesn’t openly commit to this, but he provocatively voices it to test those around him and himself. Again, I think testing it is his motive for taking the case.

    Dramatically, the whole reductionist framework sets up its refutation at the end of the episode.  House’s reductionist remarks sharpen the narrative stakes: if Adam is just a bundle of conditioned responses, then his improvement is merely mechanical. But if he is a self-aware, feeling subject, then the stakes of saving him are existential. When Adam gifts House with his electronic gaming device and looks him directly in the eyes, it is portrayed as a deliberate act that breaks through the dehumanizing gaze. House’s reductionism is refuted by its reality, and not for the first time in the series. Many viewers, I think, watch House because they themselves are as cynical as House and enjoy seeing such cynicism depicted in such a positive light. But the writers of the show do not share it. House desperately seeks love and meaning, and at the same time denies its possible reality, sawing off the branch he wishes to sit on. Even such revelations of reality as we see in Adam’s gesture seem more to perplex and startle him rather than making him seriously challenge his scientism and reductionism. That is why I call it dogmatic. It is immune from ultimate refutation, which would have to translate into House changing his life. This is beyond his power, it seems. He is in Hell while inhabiting his living body. Or is there hope for him?

 

    Something else struck me about this episode. Neither the genuine concern of the doctors nor the dutiful love of the parents had any power to reveal Adam’s humanity.  It is beyond even the most compassionate character, Cameron, that such a life could be worth living:

 

Cameron: Not much of a life for them.

Chase: They chose to have a family; you don't get to decide what your kid's going to be like.

Cameron: Nobody chooses this.

 

And this:

 

Wilson: Hope is all those parents have going for them.

 

House: No, hope is what's making them miserable. What they should do is get a cocker spaniel [cf. allusion to the veterinary hospital above]. A dog would look them in the eye, wag his tail when he's happy, lick their face, show them love.

 

Cameron: Is it so wrong for them to want to have a normal child? It's normal to want to be normal.

 

House: Spoken like a true circle queen. See skinny socially privileged white people get to draw this neat little circle, and everyone inside the circle is normal, anyone outside the circle should be beaten, broken and reset so they can be brought into the circle. Failing that, they should be institutionalized or worse, pitied.

 

Again, the line in the sand. What makes a life worth living or worth saving is to belong to the neat little circle drawn by socially privileged white people – biting sarcasm. And motivated not necessarily by moral concerns but by House’s own deep wish to be free of selfconsciousness, of the ego-drama, which he reduces like this as the exchange continues.

 

Cameron: So it's wrong to feel sorry for this little boy?

 

House: Why would you feel sorry for someone who gets to opt out of the inane courteous formalities which are utterly meaningless, insincere and therefore degrading? This kid doesn't have to pretend to be interested in your back pain or your excretions or your grandma's itchy place. Can you imagine how liberating it would be to live a life free of all the mind-numbing social niceties? I don't pity this kid, I envy him.

 

Again, this is a bond House weirdly shares with the kid and makes him different from those decent parents and doctors who pity him (and House). Part of House longs to be rid of “the pale cast of thought” (House reminds me of Hamlet sometimes.)

     But even the parents cannot fully see or affirm Adam. Their love is rooted in duty (very Kantian) rather than a response to Adam’s independent reality. They are burdened by grief, fear, and social expectations. They are as blind to Adam’s inner life as House.  At one point, House can even imagine the parents are doing this to their son:

 

Chase: Parents aren't doing or dosing this kid.

 

House: How would you know that? Kid can't talk. Why'd you think I took this case? He's not going to give away the ending.

 

Chase: They quit their jobs for him.

 

House: Yes, they are everything you'd want in a parent. Unfortunately their kid is nothing you'd want. When a baby is born, it's perfect; little fingers, little toes, plump, perfect, pink, and brimming with unbridled potential. Then it's downhill, some hills steeper than others. Parents get off on their kid's accomplishments. [House picks up one of Wilson's toys which then says "Bend over and relax".] Cute! They'll annoy you with trophy rooms and report cards. Hell they'll even show you a purple cow and tell you what a keen eye for color their kid has. But this kid, he doesn't smile, he doesn't hug them, he doesn't laugh. His parents get nothing, the right to brag that their kid picked orange juice out of a line-up.

 

Foreman: So you figure they slipped the kid a mickey so they don't have to deal.

 

The idea is that without some payoff in the ego life of a human being, acting on love can only mean sadness and loss of life energy. Since Adam offers the parents no ego-payoff, he is a burden to them, which they take on for reasons of duty and social expectation. Contrast with the love of a saint, which is reverent and non-condescending – and has the power to reveal the humanity of the most unfortunate among us. There are no saints for House. Every character is trapped in the ego-drama. That is what isolates Adam.  

     Well, perhaps House – the unlikely recipient of Adam’s self-revelation – is not as trapped as others, despite the attempt to portray him as a pathological narcissist. House shares an alienation with Adam, which is a kind of bond. There is no false comfort or projection in House. He is interested in truth. And so we get the paradox of a non-saint, a cynical reductionist receiving Adam’s gift. House’s brutal gaze makes him open to being startled; Adam’s gift interrupts House’s cynicism, refuting his hypothesis. The gesture was a clear sign of recognition, relationship, and gratitude. This was not ‘monkey see, monkey do’ but true intentionality. The absence of sentimental pity in House enabled him to earn trust. This was grace, a silent but powerful answer to the charge of being an automaton.

     Adam’s act reorients all perspectives in the episode. True sight requires love, not science and technology; dignity is revealed, not constructed. House receives what he neither sought nor intellectually believed possible, though in some dark corner of his heart I think he hoped for it. The autistic boy becomes the episode’s teacher of humanity, perhaps an allusion to the Adam of Genesis?

 

 

Another Crack at House and Reductionism/Scientism

    

     I have noticed a clear pattern or theme that is varied in different episodes that I think goes morally deep. The theme runs like this: House takes on a case partly because it seems to present a challenge to his cynical, reductionist attitude toward life and other people; he attempts to de-mean (quite literally) what challenges this attitude, to prove that what calls him into question is a sentimental illusion; then in a sublime revelation, he is refuted by a reality he cannot honestly deny; he nevertheless retreats into denial, tragically unable to change his life and thus the attitude that props it up. This suggests that the writers of the show do not share House’s attitude and want to call it into question.  

      I want to examine how this theme plays out in the episode “Lines in the Sand,”

     At the risk of repetition, I want to map House’s life philosophy again. The character fails because he keeps trying to rationally reduce everything and to accept the resulting ‘vacuum’ as what life ultimately is. He is held captive by a picture of the world and his tragedy consists in uncritically accepting the prison as the price of intellectual integrity. (Woody Allen has the same problem, but he makes something funny out of it.) House mistakes real science as a metaphysical philosophy (scientism), habitually debunking any appearance of intrinsic meaning, authentic goodness, or love by reducing it to terms other than meaning, by translating it from the language of love into a language which has no conceptual space for love or any of its related meanings, the language of instinct, selfish impulses, brain chemistry, symptoms of illnesses – a language that come from a scientific, value-free way of looking at the world as if from no place within it.

      As in everyday life we still say ‘the sun rises’ even though science has proved that the earth spins and the rising sun is an illusion, so for House we still use a language of meaning and love in some contexts even though science has proved that there is no place in the closed, mechanical system of nature for such things. This is scientism, not science, but House (like so many people) is unaware of the difference, which is this: in the case of the rising sun, there are proven ways of testing it scientifically; in the case of the real experience of meaning and love as part of reality, there is no possible way of testing it scientifically. From this it cannot be inferred that the experience of meaning is unreal unless one is prepared to assume a metaphysical theory which states that reality is nothing but what science can investigate scientifically; nothing else can be real. In that case, the realm of meaning would be an illusion, like the rising sun. But this making science into metaphysics is not itself scientific because it is not testable by any possible scientific method.  This is House’s confusion.

     Scientism is closely linked to another approach to life: reductionism. We are all familiar with what seems to be a law of human nature: before violating, destroying, exploiting, or just ignoring, we must first demean: literally de-mean, take away the meaning from whatever or whomever is to be violated, exploited, destroyed, or ignored. The forest is termed natural resources; immigrants or Jews are termed vermin, political opponents are termed terrorists, a woman you don’t like is a bitch, and so on. Reductionism, when it is not a being used legitimately in a strictly scientific context, is a form of de-meaning. A phenomenon of meaning such as loving your newborn baby or grieving over the death of your father is ‘reduced’ to radically different categories that have nothing to do with love or meaning, which in effect explain away the experience of love in particular and meaning in general away as illusions or shadowy effects of something more basically real: instinct, brain chemistry, evolution, genetics, social programming, etc. etc. Things that fit into the the closed, causally determined system of nature as science understands it. Thus  that which does not fit into the scientific picture of the universe cannot be real and must be explained in other terms that are consistent with this picture. For example, a closed system is deterministic. For anything in the system, it is predictable all the way back in time to its origin and into the future until it perishes. The position of Venus relative to Earth and Sun is accurately predictable during the time of Christ and 2000 years from now. There is no more room in a closed system to sacrifice for one’s children than for Venus to spontaneously slow down its movements, though the behavior we in our folk metaphysics may describe as sacrificing may have vastly more complexity in terms of its causes than the orbits or planets. Our experience of meaning is as naïve as our experience of the sun rising.

 

   The episode I want to look at call scientism and reductionism into question by examining them in the person of Dr. House, and what they mean for his life and actions. Scientism and reductionism are not just House’s default philosophy but it also serves a deeply rooted coping mechanism for House in his battle against what Wittgenstein called an “attitude toward a soul.”   To see another person through the lens of science is only to see them as part of a closed system of cause and effect. Science treats nature, and thus humanity, as though everything in it is causally determined (Quantum Mechanics is no exception). Like the question of whether the sun rises or the earth rotates, there is the question of whether we are really souls living in a world of meanings as in our “folk metaphysics,” or are automata following the necessities that determine the motion and changes of all matter and energy. For Wittgenstein, we cannot sanely entertain such a thought. It is not a theoretical question since to doubt our belief in the inner life is to remove the basis not only for science itself but for all attempts at making sense of anything. Here is the passage from the Philosophical Investigations (Part II, iv.)

 

"I believe that he is suffering." – Do I also believe that he isn't an automaton? It would go against the grain to use the word in both connexions. (Or is it like this: I believe that he is suffering, but am certain that he is not an automaton? Nonsense!)

 

   Suppose I say of a friend: "He isn't an automaton". – What information is conveyed by this, and to whom would it be information? To a human being who meets him in ordinary circumstances? What information could it give him? (At the very most that this man always behaves like a human being, and not occasionally like a machine.)

 

   "I believe that he is not an automaton", just like that, so far makes no sense. My attitude towards him is an attitude towards a soul. I am not of the opinion that he has a soul. [emphasis]

 

That is, this is not a question that one can have an opinion about, that can be rationally debated or scientifically investigated, since to deny it would be to saw off the branch the investigator is sitting on to investigate it. I cannot sanely entertain as a hypothesis that my sons or my classes might really be automata. The very possibility of making sense of something presupposes there is a somebody trying to make sense of something – presupposes meaning, presupposes a meaning-grasping person, a soul (in a non-metaphysical sense, as when Homer wrote a man loses half his soul the day he becomes enslaved or Weil characterized some forms of labor a soul-destroying). To regard someone as more than an organic machine isn’t merely a belief; it's an existential orientation, like giving babies names rather than numbers. Looking a suffering human being in the face, one does not wonder whether he might just be an organic machine after all. Opinions are debatable, changeable; attitude precedes and shapes how we act and experience and goes deeper than all opinions. It is not the result of reasoning because it is what makes reasoning possible in the first place.  It is prior to conscious belief. It is the lens through which one sees the world one reasons about. Saying “I believe she’s not an automaton” makes no sense: it is like saying ‘I believe the world is real and not just my dream’ or ‘in my opinion I am not really a brain in a vat connected to a computer generating a virtual world.’ I cannot prove I am not a brain in a vat but to seriously entertain the possibility is not only unhinged but negates everything. It’s not a claim to be weighed or disconfirmed; it's nonsensical outside the shared life of human beings – which House works hard not to share (increasingly as the series goes on). Raimond Gaita (whose reading of this passage I am drawing on here) links meaning of attitude here (Einstellung) to the German song lyric "von Kopf bis Fuß auf Liebe eingestellt" (“from head to toe attuned to love”). He is referring to an existential tuning: love orients you prior to all reasoning. House, however, rejects it and uses reductionism and scientism to battle against it. He takes up a different attitude – a nonhuman, alien (alienated) attitude that sees humanity from the outside, as if from no place within it (Thomas Nagel).  

     House wages war against the attitude towards a soul. He habitually treats human beings as objects – automata of a sort. When his staff treat them as human beings, he often accuses them of not being “objective,” that is, of seeing them as they really are (to him), of seeing them sentimentally. His suspicion of genuine inner life (e.g., “just autism,” “she’s chemically brave,” “tumor not baby”) reflects not just debatable beliefs, but an underlying rebellion against humanity, in others and himself. But still he cannot refrain from allowing the philosophical expression of this rebellion – his reductionism, his scientism – to be challenged from time to time, as though part of him wants to overcome it. But a powerful psychological program works against this. I will return to this after I examine the episodes.  

   One more framing thought. Blaise Pascal contrasted two kinds of knowing. On the one hand, Cartesian/empiricist reason, seeking certainty method, measurement, and clear and distinct ideas (Descartes) or sensory verification (Locke, Hume). It operates only within what can be explicitly stated and proven and tends to reduce reality to what fits the method. This is House’s idea of reason, and it goes deep in him is part of what makes him a brilliant physician. On the other hand, there are the “reasons of the heart.” As Pascal wrote: “The heart has its reasons of which [rationalist, empiricist] reason knows nothing.” This is not irrational, but supra-rational: we see someone’s dignity, or love’s reality, immediately, as an attitude of the soul rather than as a conclusion from data. This is close to Wittgenstein’s attitude towards a soul.  It is a kind of attunement to another’s humanity that comes before opinion or proof.  

     House lives almost entirely in the Cartesian/empiricist world. He wants empirical verification, observable causation, and measurable symptoms. He wants technological and scientific control of nature (the human body), a control he ironically does not have over his own body. This is why he often treats moral beauty, love, bravery, or even personhood (the soul) itself as hypotheses to be tested or dismissed if they can’t be confirmed physiologically. That stance is already a decision of the heart, an attitude based on the rejection of an attitude towards a soul. It tunes him away from seeing other human beings as living souls. But again, in all the episodes I want to discuss, he cracks open the door, light comes in, but he proceeds the close the door again.