House of pain, and pleasure

If House is a guilty pleasure, deal with it. Tell yourself, yes, we do need another steadycam roaming the sterile halls of death and decreptitude. And don't feel alone. There are plenty of other fans, though I take personal responsibility for it going to another series.

House gives Hugh Lawrie and his piercing blue irises an opportunity to be grumpy, sarcastic and throw a vague, not-really-concerned missile at the dartboard of American accents. Perhaps the guilt comes from it being a Fox show, and thus spawn of the devil, and the fact that it lures you in to the last scene every time.

Setting aside the careful writing and intelligent performances, House appeals, I think, because it presents a world in which every ailment can be cured, every medical mystery solved, given enough diagnostic firepower, the appropriate barrage of horrendously expensive hospital tests and weapons-grade pharmaceuticals. This suggests that a) medical knowledge is approaching a kind of completeness and so can cure all ills and that b) there's someone behind the beeping machines and x-rays who really, really cares. He'll fight your corner even if it costs his job.

Your typical Western health system, sadly, is a long way from this med-utopia. AIDS is no longer a certain death sentence in the West, but there is no cure. There are jabs for flu, but the damn thing mutates like a reality TV series format. Some cancers won't get better; they'll just give your family enough time to pick the right shade of peony for the wreath.

And experts get it wrong. And they guess. And they don't really know. That's why there's NSU and IBS, non-specific urethritus and irritable bowel syndrome. Basically, we know that there's something wrong, and we have drugs that often alleviate these kinds of things, but we really don't know much more. And if you take the point of view of people like James Le Fanu in The Rise and Fall of Modern Medicine, there's trouble in medical Eden. Fewer breakthrough new drugs are being created that really work against the very bad things, he argues, and technology is limited and often ill-used.

House, of course, fetishises technology and pharmacology.

Lawrie is in line for outstanding lead actor in a drama series in the Emmys in September, just after the new series starts in the US. Mainly, I suspect, it's for feigning a limp and a raging Vicodin addiction. And for being a bit of a sod when most people on US TV are not. Even difficult people, such as Frasier Crane, are likeable. House is not what you'd call likeable; he's not unlikeable – he just more admirable. He's moral and relentlessly ethical. But he's also blunt and sarcastic and small talk-free. The award nod means nothing at all for the programme's viewers, other than reinforcement that he's not just a funny man; he's a dramatic funny man, who went to Eton and Cambridge. Very posh. And quite smart. Must be why they've introduced a love interest.

He needs to be smart, of course, to reel off emergency room shorthand and not sound like ER on P.

But of course there's no actual love in the interest. House, so far in the series (five episodes to go), has blanked his enamoured cute (and smart) subordinate, and continued the sexual fencing with his cute boss. In passing, he's seen off the double-breasted giant of a CEO who wanted to fire his rule-breaking, unconventional ass and run the hospital as a business, and lost the giant's $US100 million in the process. Yeah right.

His mate helped him. His mate is the chief oncologist, who is the guy at the hospital you really don't want to get to know well if you're a patient. He's played by Robert Sean Leonard, who you may remember as the student who popped himself in Dead Poets Society. There's also the brash Aussie doctor who wants to undermine him, and the smart black doctor, who wants to be as tough but can't be. But House is the undisputed guy in control. No one's as clever, as thinky, as confounding.