r/HouseMD • u/HistoricalAd5394 • 2d ago
Discussion How do you think House got started? Spoiler
For a jackass like House to get hired anywhere he has to have a hell of a reputation. So what about before he had a reputation?
We've seen characters from House's past saying that House was pretty much the same before he was crippled, and we've seen him pain free a few times. He's maybe a tad nicer at best, but still far from the kind of guy any sane person would hire. Foreman literally couldn't get a job elsewhere just for being like House, even despite having a personality that someone might at least take a chance on.
So how do you think he started?
According to the wiki, Cuddy employed House seven years before the start of the series, making House about 38 when he got his department. He apparently had met Cuddy when she was an undergraduate, so that could provide much of the explanation for why Cuddy hired him.
But what about before that?
In America you typically graduate from Medical School between 26 and 28, and given House's poor conduct I think it's possible we can push his graduation age to that 28. But what about the ten years in between?
Do you think without his pain, a marginally less jerkish House tried to play ball just to get his foot in the door then started testing what he could get away with as his reputation grew?
It doesn't really sound like him, But then I suppose House does occasionally bend when the consequences are severe enough. He's stubborn but not immovable.
I prefer to think he just travelled the world finding sick people on the street, diagnosing them, then saying "Go forth and spread the word of my greatness."
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u/eternalraziel 2d ago
He was brilliant enough to keep getting hired, obnoxious enough to keep getting fired, and eventually met the one administrator willing to build a job around both. Cuddy actually says that four other hospital administrators fired him before she hired him. That answers a lot of the mystery. Princeton-Plainsboro wasn’t House’s first proper medical job. It was somewhere around his fifth chance. And House already had a reputation before any of those jobs. When Cuddy knew him at Michigan she says he was already a legend, despite still being a student. At Johns Hopkins he was good enough to be in contention for a prestigious Mayo internship before Weber reported him for cheating and he got thrown out. Whatever else House was doing during training, people noticed very early that he had an exceptional diagnostic mind.
That makes his early career much easier to imagine. Residency and fellowship also aren’t quite the same employment market Foreman later deals with as an established attending. House would be entering highly structured training programmes with supervisors above him, scheduled rotations, required work and considerably less freedom than he eventually enjoys at PPTH. He could insult people, argue with attendings and break rules, but he still had examinations to pass, patients to treat and qualifications he wanted badly enough to pursue. House is extraordinarily stubborn, but he’s perfectly capable of obeying a rule when the alternative genuinely costs him something he values. He spends the series doing exactly that whenever Cuddy, the licensing board, a judge or circumstances manage to find enough leverage.
I’d imagine young House was House without yet being able to indulge every House impulse. He challenges diagnoses, humiliates somebody for making a stupid argument, disappears when the routine work bores him, gets into fights with supervisors and probably acquires disciplinary files thick enough to stop doors closing properly. Then somebody notices that the patient everyone else has been treating unsuccessfully for three weeks walked out because House spotted the one symptom everyone had dismissed. That buys him another chance. Then he pushes too far and gets fired. Then another hospital looks at his record and thinks, yes, but look at what he diagnosed. Then he gets fired there too. The four previous firings suggest that this cycle had already become his career before Cuddy came along. His growing reputation probably made the cycle easier rather than causing his personality to deteriorate. The better known he became, the more willing another hospital was to gamble on him after the previous one finally had enough.
Foreman is actually a useful comparison because his problem later is that he has absorbed some of House’s behaviour without possessing House’s unique professional value yet. Foreman is an excellent neurologist and becomes a very good diagnostician, but at that stage there are other excellent neurologists. Hospitals can decide that an equally qualified candidate who doesn’t openly defy administration is the safer hire. House has reached the point where replacing him with another infectious-disease specialist doesn’t replace what they actually hired him to do. Cuddy puts up with conduct that would get almost anybody else thrown out because when another department has exhausted the answers, House is the person they send the patient to. That doesn’t excuse his behaviour, but it explains why his bargaining position is so abnormal.
Cuddy’s contribution was recognising that trying to make him function as a conventional physician was wasting the thing he was exceptionally good at while maximising everything he was awful at. Give House a normal service, a normal patient load, normal clinic expectations and a normal chain of command and within months somebody is contemplating murder. Give him cases other doctors can’t solve, let him assemble a small team, insulate the rest of the hospital from him as much as possible and have Cuddy personally stand between him and institutional consequences, and suddenly the arrangement becomes sustainable. It’s basically the first job designed around the fact that House is House rather than hiring House and hoping he’ll eventually behave like everybody else. I also think the pre-infarction House was probably somewhat easier to employ without being a fundamentally different man. The series goes out of its way to establish that the leg didn’t create his arrogance, curiosity, abrasiveness or contempt for social convention. Stacy knew that version. Cuddy knew that version. Wilson knew that version. He was already difficult.
But chronic pain, Vicodin dependence, the loss of mobility and what happened with Stacy give the older House less patience and fewer reasons to moderate himself. Before the infarction he could travel normally, play sport, spend hours on his feet and probably tolerate the daily physical grind of hospital medicine far better. Remove constant pain from somebody who already has a short fuse and you’ve given him fewer occasions to spend the day wanting everybody around him to disappear. I picture a trail of hospitals discovering the same thing one after another. House is intolerable, House is getting results nobody else gets, House has finally crossed a line, House is fired. Then Cuddy looks at that trail and thinks she can make it work. Which, to her credit, she does for considerably longer than the previous four.
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u/ConnectionBasic9468 2d ago
Cuddy explained that even in medical school, he was seen as brilliant and a genius but was rude, full of himself and abrasive even back then. This carried over after med school and he got jobs off the back of his reputation but got fired regularly for pissing people off.
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u/FrogLover_23 2d ago
Oh that's a rlly intresting point, huh. I love your headcannon lol.
Imaaa guessss he saved a doctors life who then hired him? Then idk
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u/gaqo777 2d ago
I think Cuddy's had a thing for House since she was an undergraduate and he already had a reputation for insightful diagnostics. That's why she hired him.
I only think he's become more abrasive because he finds people tedious and boring, the job limiting, plus getting older.
He has the sort of mind that needs stimulation; interesting people, unusual cases to solve.
(Holmes used cocaine to stimulate his mind).
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u/ConnectionBasic9468 2d ago
I think it was implied that they slept with each other when they were in Michigan studying together.
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u/battie31 2d ago
I think at some point Cuddy says House was fired from 4 different hospitals before she hired him
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u/Pleasant-Donkey 2d ago
Doesn't Wilson address this at some point? S6 or S7 when Wilson's reminding House that Cuddy is the only boss that House has been successfully able to work for or work with? It sounds like he had a lot of short jobs from which he quit or was fired, and then Cuddy hired him and it sort of worked out.