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"Pilot", also known as "Everybody Lies," is the first episode of the medical drama House. The episode premiered on the Fox network on November 16, 2004. It introduces the character of Dr. Gregory House (played by Hugh Laurie)—a maverick antisocial doctor—and his team of diagnosticians at the fictional Princeton-Plainsboro Teaching Hospital in New Jersey. The episode features House's attempts to diagnose a kindergarten teacher after she collapses in class.

House was created by David Shore, who got the idea for the misanthropic title character from a doctor's visit. Initially, producer Bryan Singer wanted an American to play House, but British actor Hugh Laurie's audition convinced him that a foreign actor could play the role. Shore wrote House as a character with parallels to Sherlock Holmes—both are drug users, blunt, and close to being friendless. The show's producers wanted House handicapped in some way and gave the character a damaged leg arising from an improper diagnosis.

The episode received generally positive reviews; the character of House was widely noted as a unique aspect of the episode and series, though some reviewers believed that such a cruel character would not be tolerated in real life. Other complaints with the episode included stereotyped supporting characters and an implausible premise. The initial broadcast of "Pilot" was watched by approximately seven million viewers, making it the 62nd-most-watched show of the week.

Plot

Shortly after the start of class, kindergarten teacher Rebecca Adler becomes dysphasic and experiences seizures. Dr. James Wilson attempts to convince Gregory House to treat Adler, but House initially dismisses him, believing that the case would be boring. Hospital administrator Dr. Lisa Cuddy approaches House in the elevator and attempts to persuade him to fulfill his duties at the hospital's walk-in clinic. House refuses, claiming that Cuddy cannot fire him due to tenure, and hurriedly leaves. When House's team attempts to perform an MRI on Adler, they discover that House's authorization for diagnostics has been revoked; Cuddy restores his authorization in exchange for his working at the clinic.

Adler's throat closes up during the MRI due to an allergic reaction to gadolinium, prompting two members of House's team, Dr. Robert Chase (Jesse Spencer) and Dr. Allison Cameron (Jennifer Morrison), to perform a tracheotomy. In the hospital's clinic, House's first patient is a man who is orange because of an over-consumption of carrots and vitamins (niacin). House also treats a ten-year-old boy whose mother allows him to use his asthmatic inhaler only intermittently instead of daily as prescribed. House criticizes the mother for making such a drastic medical decision without first learning more about asthma. During his monologue, House stumbles on an idea and leaves quickly to treat Adler; he diagnoses her with cerebral vasculitis, despite having no proof. House treats Adler with steroids, which improves her condition greatly for a time, until she starts seizing and has heart failure.

On House's insistence, neurologist Dr. Eric Foreman and Cameron break into Adler's house to find anything that might account for Adler's symptoms. They find an opened package of ham in Adler's kitchen and House concludes that she is suffering from neurocysticercosis from eating undercooked pork at some point in her past. Adler refuses to accept more random treatments unless there is conclusive evidence that the diagnosis is correct. House is ready to dismiss the case when Chase provides an idea for noninvasive evidence of Adler's tapeworm infection; by taking an X-ray of her thigh, House proves that Adler is infested with other tapeworms and her condition is treatable. After seeing the evidence, Adler agrees to take medication to kill the tapeworms.

Production

In 2003, executive producers Katie Jacobs and Paul Attanasio approached David Shore about developing a series with them. Attanasio, inspired by the "Diagnosis" column in The New York Times Magazine, suggested a medical-themed procedural. Shore was initially not eager about the medical focus, but found the networks they pitched to were interested in the concept. The trio pitched House to the Fox Broadcasting Company as a medical detective show—a hospital whodunit where the doctors would be the sleuths looking for the source of symptoms. The ideas behind House's character were added after Fox bought the show. Shore was inspired by a vivid memory of a doctor's visit: he once had to wait two weeks to get a doctor's appointment for a sore hip, by which point his pain had disappeared. Nevertheless, he went to the appointment, and Shore recalled thinking they were "incredibly polite" even as he wasted their time; he liked the idea of a doctor who would have been blunt with their patient. Shore said that the writings of Berton Roueché, a The New Yorker staff writer who chronicled intriguing medical cases, inspired the plots for "Pilot" and other early episodes.

As Shore developed an outline for the show, he was afraid it was developing into a more character-focused series, rather than a procedural. Attanasio suggested not showing the network an outline, and instead giving them a full pilot script. The pilot took Shore five months to write, and the completed script was delivered in early 2004. Shore recalled there were relatively few changes to what he wrote; one significant change was moving the setting from Boston to Princeton. Director Bryan Singer suggested the change because he had grown up in Princeton and liked the smaller, more academic-focused setting that was more unique on television.

A key element of the show's premise was the handicapped main character. The initial idea was for House to use a wheelchair, but Fox turned down this interpretation (for which the crew was later grateful). The wheelchair idea turned into a scar on House's face, which later turned into a bad leg necessitating use of a cane.

After Fox green-lit the pilot, the production began casting. House's casting directors had previously worked on Jacobs and Attanasio's series Century City. While ideally the production would have cast their lead and then built the cast around them, the competitive rush of pilot season meant that roles were filled whenever they could. Wilson was the first role cast, followed by Cuddy and Cameron. Laurie was not cast as House until two weeks before photography for the pilot commenced. Laurie had put together an audition tape in a dingy hotel bathroom in Namibia while shooting Flight of the Phoenix, using an umbrella for a cane. The roles of Chase and Foreman were cast soon after.

The episode was shot in Vancouver, Canada; later episodes would be shot on soundstages in California. The show was not called House until days into filming. The music was composed by Christopher Hoag in his only work for the series; subsequent episodes would be scored by Jon Ehrlich and Jason Derlatka.

Similarities between House and the famous fictional detective Sherlock Holmes appear in the pilot; Shore explained that he was always a fan of Holmes, and found the character's traits of indifference to his clients unique. House and Holmes have only one real friend (Wilson and Watson, respectively) who connects the cerebral hero to human concerns. This Holmes and Watson dynamic was something the producers were looking for in the characters of House and Wilson, especially in terms of chemistry.

Analysis

"Pilot" establishes much of the formula the series would heavily rely on for the structure of most of its episodes; this predictable structure would be considered part of the show's appeal. The episode opens with a "teaser" that shows the individual's medical mystery that House and his team will diagnose; the middle showcases House's unorthodox methods, including breaking into a patient's home to identify a possible cause for the illness; possible diagnoses are discussed using metaphors for the benefit of the viewer; and the "eureka" moments where a sudden insight reveals the true diagnosis. The recurring theme that "everyone lies" is repeatedly underlined throughout the episode, beginning with the patient's lies to their coworker in the teaser. On rare occasions, such as "Pilot", the notoriously patient-averse House pays Adler a bedside visit, revealing details of his personal history in an effort to convince her to fight for her life. It also sketches out the main aspects of the cast and their relationships, particularly House's focus on unique or uncommon medical diagnoses, his dry personality, and his relationships with Wilson, Cuddy, and the team. In comparison with later episodes, "Pilot" has a greater focus on the patient, and some character elements are adjusted as the series continues; House is much more casually-dressed, and the diagnostic team are less at a remove from their boss. Another staple of the earlier episodes is the clinic visits House reluctantly takes in "Pilot", which break up the tension of the main case and intersperse comedic beats.

Reception

House's premiere episode was generally well received. Critics reacted positively to the character of House; Tom Shales of The Washington Post called him "the most electrifying character to hit television in years." New York called the series "medical TV at its most satisfying and basic," and stated that the cast consisted of " actors playing doctors who come to care about their patients," while The Boston Globe's Matthew Gilbert appreciated that the episode did not sugarcoat the flaws of the characters to assuage viewers' fears about "HMO factories." Alessandra Stanley of The New York Times said that though the characters might be a turn-off to some viewers, the gore and "derivative gall" of the show were positives to fans of procedural dramas; TV Guide's Matt Roush stated House was an "uncommon cure for the common medical drama." Critics of The A.V. Club called House the "nastiest" black comedy from Fox since the 1996 short-lived television series Profit. Critics considered the series to be a bright spot among Fox's otherwise reality television-based broadcast schedule.

The episode's format was compared to a rival television series, Medical Investigation. USA Today favorably stated House as more character-driven than Investigation's "plot-driven procedural," and the San Francisco Chronicle felt that House was the better show due to the title character. Variety's Brian Lowry, meanwhile, stated that the two shows were too similar and House was mismatched among Fox's other programs. Other complaints included perceived stereotypes of young, attractive doctors. Sherwin Nuland of Slate gave the first episodes of the series a highly negative review, stating that "Of all the medical errata in this series (and there are some whoppers), the greatest is surely the conceit that a physician so remote, so neglectful of duty, so sadistic, so downright cruel as Gregory House would be tolerated in any hospital." Kay McFadden of The Seattle Times felt that Laurie's portrayal of House humanized the character, but also revealed the show's deepest flaw: "a reliance on shallow cuteness for comic relief." Other complaints included a lack of characterization for the supporting characters in the first few episodes.

The premiere attracted approximately seven million viewers in the United States, making it the 62nd-most-watched show for the week of November 15–21, 2004. The United Kingdom terrestrial premiere was broadcast on June 9, 2005, by Five and garnered a ten percent share (1.8 million viewers). Christopher Hoag, who composed the music for "Pilot" and the first season of House, was nominated in the 2005 Primetime Emmy Awards for Outstanding Music Composition for the episode. Shore received a Humanitas Prize nomination for writing the episode, but lost out to John Wells, who wrote the episode of The West Wing entitled "NSF Thurmont". Fox marketing Vice President Chris Carlisle promoted the show by distributing nearly two million free DVDs of the program through Entertainment Weekly and People.

References

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• House M.D. Season 1 — Special Features (DVD). Universal Studios Home Entertainment. August 30, 2005.
• Challen, Paul (2007). The House that Hugh Laurie Built. ECW Press. ISBN 978-1-55022-803-8.
• Barnett, Barbara (2010). Chasing Zebras: The Unofficial Guide to House, M.D. ECW Press. ISBN 978-1-55022-955-4.
• Jackman, Ian; Laurie, Hugh (2010). House, M.D.: The Official Guide to the Hit Medical Drama. HarperCollins. ISBN 978-0-06-187661-5.

External links

• "Pilot" at Fox Broadcasting Company
• "Pilot" at IMDb

• House (season 1) episodes
• American television series premieres
• 2004 American television episodes