Credibility at last, thanks to House

Whether or not the public knows it, they buy nerve injury pain every week on Tuesday night when they watch House.


Hugh Laurie is a British actor/author who is sort of the Mark Twain of British commentary, and a fascinating performer. We begin this piece with some quotes from “The Gun Seller” a novel Laurie penned which many admire, or at least enjoy laughing at, which is even better. Laurie is speaking about pain. Already you are curious.

Not uncharacteristically for the practically minded British, Laurie the author, is not willing to embrace the psychobabble that passes for science, where pain is concerned, in the United States. You know the routine. Pain is the invention of weak minds, mostly placebo treatable, has only a psychological origin and what is all the fuss about anyway–buy my book (which includes many painless soldier stories and shark bite tales in place of data), and it will all go away, INSTANTLY.

Lang, the quasi-hero of “The Gun Seller” says:

“A…combat instructor called Cliff…once told me that pain was a thing you did to yourself. Other people did things to you–they hit you, or stabbed you, or tried to break your arm–but pain was of your own making.”

Cliff’s qualification to be an expert on pain was a fortnight in Japanese captiviy, by consequence of which Cliff “so felt entitled to unload dogshit of this sort on his eager charges, it was always within your power to stop your own pain.”

Lang states, “Pain is an event. It happens to you, and you deal with it in whatever way you can.”

Now the above mentioned truths, however obvious, continue to be the subject of controversy among behavioral scientists, who just coincidentally also believe everything that is wrong in your life can be traced to the Oedipus Complex you had for your mother. The way Lang (Laurie) says it is obviously obscene, but nowhere nearly as obscene as the brutal indifference to pain by those who have not the slightest idea what they are talking about. Incidentally, these experts, despite their PhD’s in Job’s Comfortorology, turn from Smeagle to Gollum and collapse into whimpering trembles and howling madness at the slightest injection of capsaicin, which does in fact hurt, about one hundredth as much as Central Pain, and briefly, as opposed to lifelong.

The bottom line is that we like Laurie’s take on pain. It should be obvious–any child knows the truth of it as well as that the Emperor has no clothes, but this doesnt’ stop the “experts” from concluding, sternly and condescendingly, that YOU are the cause of ANY pain you suffer. Next to this preposterous heartlessness, “dogshit” seems like proper English.

Still, to show how learned we are, we will refer to it instead in the more scientific term of the great German pain researcher, Dr. Josef Mengele, which is “hundscheit”. This also was a name affectionately conferred upon him by Auschwitz inmates who were the subjects of Mengele’s experiments, such internees being famous for “what they did to themselves” (painful experiments leading to death), while Mengele merely observed and documented. The Auschwitz inmates had helpful slogans supplied to them, especially their “Arbeit macht frei” and we have our slogans thoughtfully supplied to us by behavioral scientists, “Hundsheit macht frei”.*

Laurie currently can be seen in the TV series, “House” which as interesting as any medical show has ever been, and far more realistic. It has been described as the cure for the ordinary banal medical TV show. In the series, Dr. House has nerve injury pain. How likely is that?

Hugh Laurie as Dr. House limps around on his painful leg, trying not to use it, sneaks his pain pills, and grimaces as he endures the leg. In case you missed the earliest episode, House had an infarct (clot) in the leg which cut off blood supply and caused nerve damage, and more specifically, nerve injury PAIN.

Possibly, it is reflex sympathetic dystrophy, aka causalgia, now called Complex Regional Pain Syndrome. It is a peripheral nerve injury state, but nerve injury pain nevertheless. Since the Vicodin helps him, it isn’t completely real life, but the pills are just symbolic anyway, of his struggle to be God when he is after all, a flawed human. Since you can never find words to describe central pain burning, but must always borrow from other pains, acquiring Central Pain has always been like stepping into a metaphor anyway, as Lang would have said.

We know a firefighter who lept from a burning building and injured the nerves in his legs and feet who now has burning and has to sleep with his legs extended over the end of the bed in air, who shows no atrophy and does not have CRPS, so maybe House has something like that, ie NOT CRPS. Either way, you can tell people you have “House” syndrome, but a worse variety, since cord/brain injury makes it cover the entire body. Yes, YOU might actually get some credibility regarding your central pain. Hard to believe isn’t it! Now if House just walked around with one leg uncovered because he cannot stand the touch of clothing, the convincing power of Hollywood would be even more powerful, but….

Many of you know, House is the withdrawn, cynical, grumpy, and bright diagnostician who manages to save lives despite his leg really killing him and an obvious addiction to opiates (Vicodin, ie hydrocodone). Although it isn’t discussed nearly enough, maybe House will get around to saying more about his injury. What he HAS said is nothing short of classic. His beautiful boss, who obviously has a crush on House. endures his brattiness because she thinks eventually he will fall for her. Of course, the viewer knows House is “not available”. His pain has made him no fit company for anyone, but he is still in there pitching against disease. Relating to illness is, as another show mentions, ALL House has.

Bless their hearts, the writers portray accurately the usual response of those NOT in pain. His boss sees him hustling the pharmacist for more pain pills and begs him to admit he is addicted. House replies, more or less, “Yes, moderation is wonderful thing, EXCEPT when there’s PAIN.” That about says it all. She does convince him to give up Vicodin for a month. This of course puts him back into severe pain and he can hardly function, seconding those who dislike his skill and are jealous of him. There is a scene where he deliberately breaks the bone in his hand so he won’t feel his leg pain. Score one for the writers who realize nerve injury pain is more severe than ordinary pain. A particularly difficult case comes in, and the African American neurologist who is a detractor finds House vomiting into his desk drawer. He tells House he is in withdrawal and here again, the amazing knowledge, House tells him PAIN makes you vomit, not withdrawal. (Most of us with severe CP can vouch for this. I have had my nauseated by pain episodes). Eventually, realizing the patient will die without House at his best, the neurologist, House’s antagonist, secretly supplies House with Vicodin, and with the pain eased, House makes the critical diagnosis.

House’s amazing intellect and powers of endurance are contrasted against pain as his Achille’s heel, or should we say Achille’s Hell. Either way, we win. You now have a national TV show which sends a message. Take advantage of it. Write to the producers and let them know about your own nerve injury pain and thank them for portraying it. We can use all the publicity we can get. And we are serious about renaming nerve injury pain, “House” syndrome.

If House runs for several seasons, maybe there could be a sequel, with a Dr. House who attempts surgery to improve his leg but things go terribly wrong and he suffers an SCI on the operating table and develops Central Pain. After that, he could sit around in a Speedo, since he can’t stand the touch of clothes, still making all those wonderful diagnoses but spending less time being arrogant and more time explaining that he is not faking, it was not God’s will, and it was not so he could learn something, since he already knew everything.

House never sleeps anyway so that won’t change. He can still have his sofa bed but he won’t be able to lay on it since touch burns. The hospital boss would have nothing to do with him because he is now beyond weird; and his loss of working memory will make it extra tough on him. That would be interesting. He also wouldn’t have any teeth left because all the tricyclics would have dried out his mouth and ruined them, but since House never smiles, that will not be what holds him back. His handicaps would give a bigger role to the other three doctors who work with House, and are much better looking. House would be out of commission. He would just sit there doing nothing except holding on, like us.

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“Arbeit macht frei” means “Work will make you free”, while “Hundscheit macht frei” means “Buy my pain attitude book on Amazon.com and your pain will magically disappear”. Both sayings are from the same genre of “Considerably less than fully accurate” literature.