House MD--pilot

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EFL Movie Study Guide for: House MD, pilot (first show of season 1)


Introduction: I show medical students parts of this “first drama” (i.e., premiere or pilot) of an American TV show to introduce the characters and to facilitate a discussion on pain. In this episode, a young teacher loses the ability to talk and then faints. Diagnosis is difficult. At first, it is treated like a tumor, then vasculitis, and each treatment raises questions that we can talk about after the show. (my version is 32 minutes)



Dr. House: Head of Diagnostic Medicine

Dr. Cameron: one of three young doctors; the only female on this team

Dr. Chase: the second young doctor; from Australia

Dr. Foreman: the third young doctor; an African-American

Dr. Wilson: a slightly older doctor (oncologist?), who is also a friend of Dr. House


Note 1: This TV show uses a lot of *sarcasm; that is, they say things that are the opposite of what they mean, in order to make an unkind joke or to show that they are annoyed.


Dr. H says to Dr W: “You’re the renowned [famous] oncologist; I’m just a lowly infectious-disease guy.” (Dr. H. really meant that his own specialty was more important in this case than the other doctor’s specialty.)

Dr. C: “Was she lying? Yes, the patient probably knew she was allergic, and figured it was an easy way to get someone to cut a hole in her throat.” (Dr C. meant that the patient wasn’t lying about her medical condition, she just didn’t know she was allergic—and this almost killed her.)

Dr. W: “Look into this case. Don’t leave all the fun for the coroner.” (Dr W isn’t saying that it is “fun” for the coroner to determine why the patient died, he is asking Dr H to get involved and hopefully to prevent death.)

Note 2: At one point you hear them say that a worker earns $8 per hour; in America this is not much! Just to talk to a doctor can cost $100; many college textbooks also cost $75 to $100 (each).


*A few phrases:

to babble like a baby: to “talk” without making sense (“After taking the medicine, she babbled like a baby for a minute before falling asleep.”)

change--“Do you have change for a dollar?” This means “please give me coins instead of this dollar, so I can buy something from a machine that doesn’t take paper money.”

“He’s a delinquent.” This means that, as a youth, he broke the law or did socially unacceptable things.

“Good call.” This means “You made the right decision.”

intermittent problem: something that is sometimes wrong or bad, but sometimes fine (“This muscle has an intermittent problem; three times last week it hurt but most of the time it is OK.”)

to screw up: to make a mistake (see dialog 3)

to trigger a response: the trigger is the “button” you push to make a gun fire, so this is talking about the situation or cause of a response or reaction

to trust sb implicitly: to believe sb completely without doubt (“If I were her student I would trust her implicitly.”)


Medical terms:

*allergy/allergic reaction: a condition that makes you ill (or gives you skin problems, etc) because of contact with something your body can’t handle (e.g., an insect bite, oil from some plants, chemicals in the air); when you get sick because of an allergy it is called an “allergic reaction.”

aneurysm: when a blood vessel (or artery) is filled with too much blood (esp. due to disease)

biopsy: the removal of cells from a body so that they can be examined for disease

*CT/CT scan ( or CAT scan): a device (also process or result) that gives a sectional (3-D) picture of the inside of someone’s body (I believe the letters come from “Computed Tomography”)

coroner: an official whose job is to determine why sb died, using medical tests

*diagnosis/diagnostic/diagnostician: the process and tests used to find out what an illness is (diagnostic is an adj; a diagnostician is a doctor with this specialty)

*genetic: related to the part of a cell that controls its characteristics or development (遗传性)

HMO: Health Maintenance Organization--an medical organization that provides health care to members under a group insurance plan (often without giving patients many choices)

*hygiene: common practices (such as washing one’s hands and throwing out trash) that make you and your environment clean, esp. to prevent illness

*the immune system: immune system: [c] the parts of your body that work together to protect you from disease

*to inject (into a vein): to put (medicine) into the blood through a needle

lesion: damage to skin, brain, etc., caused by injury or sickness

MRI: Magnetic Resonance Imaging--a process that creates a picture of the inside of your body, using strong magnetic fields (磁铁?)

*nerve: the “wires” inside your body that carry information to and from the brain

neurocysticercosis: infection of the central nervous system due to tapeworms

neurologist: a doctor whose specialty is the body’s nervous system (network of nerves)

oncology/oncologist: the study of tumors/a specialist in this field

*oxygen: an important element in our air (氧气)

*parasite: a plant or animal (e.g., a worm) that can’t live except by being part of another plant or animal

*sanitary: (adj) describing something that is especially clean or free from infection, bacteria or other unhealthy things; also called “hygienic”

seizure: a short, sudden loss of control of one’s body (often due to illness or a negative reaction to drugs)

steroid: a chemical (or drug) that can fight illness or build muscles

*tumor: a useless mass of cells in your body that have multiplied too quickly (some are dangerous and some are not)

vasculitis: inflammation of a blood vessel (in this story, it is in the brain)

*to ventilate: to pump oxygen into a patient’s lungs

stroke: a serious medical condition when an artery in the brain bursts or becomes blocked

ischemic syndrome or condition: related to a lack of blood (e.g., to the brain or heart) because something is partially blocking the arteries

vascular: related to the tubing system that carries body fluids (esp. blood)


*Sentence pattern:

What happens when you give steroids to a person who  has a tapeworm?

What happens when you tell bad news to a person who is already feeling bad?

What happens when you sell fake medicine to a person who is in terrible pain?

What happens when you ______________ to a person who ______________?


Dialog 1:

Patient: Doctor, I still feel a lot of *fatigue. (i.e., he is tired a lot)

Dr: What are your other symptoms?

Patient: Headaches, mild fever, sometimes I can’t sleep, I have trouble concentrating.

Dr: What medicine did your other doctor prescribe?

Patient: Vicodin.

Dr: That is very strong pain medicine.

Patient: I think I need a refill.


Dialog 2:

Dr. Chase: “You shouldn’t have told her this might cure her. It’s a long shot guess.”

Dr. Cameron: “Perhaps, but I’ve given a dying woman a couple days’ hope.”

Dr. Chase: “False hope.”

Dr. Cameron: “If there was any other type of hope available I would have given her that.”


Dialog 3:

Dr. House: “I don’t trust patients because everyone lies.”

Dr. Foreman: “Can we trust the blood test results from another hospital? I assume it’s a corollary if ‘people lie’ that ‘people screw up’.”

Dr. House: “Right. Do the test over.”

Dr. Foreman: “Should we talk to the patient?”

Dr. House: “Yes. Everybody lies, but truth begins in lies.”

Dr. Smith: “The most important thing is not what people say. It’s what they do.”


Dialog 4:

Patient: Doctor, how did the tests come out?

Dr: The protein markers for the three most prevalent brain cancers came up negative, so you don’t have cancer. You are not responding to radiation treatment, so it isn’t a tumor. The problem is a parasite.

Patient: Doc, I have decided that I don’t want any more treatments. I don’t want any more experiments. I want to go home and die.

Dr: You’re being an idiot. You have a tapeworm in your brain. It’s not pleasant, but if we don’t do anything you’ll be dead by the weekend.

Patient: Have you actually seen the worm?

Dr: When you’re all better, I’ll show you my diplomas. Patients always want proof. We are not making cars here. We don’t give guarantees. But I’m pretty sure about this.

Patient: You were sure I had vasculitis, too, and prescribed steroids—that experiment failed. Now I can’t walk and I’m wearing a diaper. What’s this treatment “gonna” (going to) do for me?

Dr: I’m not talking about a treatment. I’m talking about a cure. But it is strong medicine. Possible side effects include abdominal pain, nausea, headaches, dizziness, fever and hair loss..

Patient: What if you are wrong?

Dr. Because I might be wrong, you want to die?

Patient (after a pause): What made you a cripple?

Dr: I had an infarction.

Patient: A heart attack?

Dr: It’s what happens when blood flow is obstructed. If it’s in the heart it’s a heart attack. If it’s in the lungs, it’s a pulmonary embolism. If it’s in the brain it’s a stroke. I had it in my thigh muscles.

Patient: Wasn’t there something they could do?

Dr: There was plenty they could do, if they had made the right diagnosis. But the only symptom was pain.  Not many people get to experience muscle death.

Patient: Did you think you were dying?

Dr: I hoped I was dying.

Patient: So you hide in your office and refuse to see patients…because you don’t like the way people look at you.

Dr: People don’t want a sick doctor.

Patient: You feel cheated by life, so now you’re going to get even with the world. But you want me to fight this. Why? What makes you think I’m so much better than you?

Dr: What…you’re scared you’ll turn into me?

Patient: I just want to die with a little dignity.

Dr: There’s no such thing. Death is always ugly. We can live with dignity. We can’t die with it.



Everyone work on these:

1. List the people who experienced “pain” in this show. What do you do when you are in pain?

2. Tell your partner one thing you learned from this show, either about medicine, English, or something else. Be ready to tell the class what your partner says.


Key questions:

3. In this case (and most cases in this TV show), diagnosis was very difficult. Why?

4. Dr. House told Dr. Foreman to break into the patient’s house to look for medical clues. Do you think he should have asked the patient for her key instead? Why or why not? Do you think Dr. Foreman should have said “no”?

5. House said he had hired Foreman because he needed someone with “street smarts.” What criteria should doctors use when they hire others? Explain your answers.

6. Should people always try to get rid of pain, or can pain be a good or “normal” thing?

7. What is a doctor’s responsibility in relation to the pain his/her patient feels? Should the doctor deal with pain, or only deal with illnesses and other problems?

8. Dialog 4 helps us see why Dr. House is always in pain. Can you understand why he is often sarcastic, irritable and unhappy? Do you think this behavior is acceptable? Explain.

9. If doctors earn a high salary, then medical care must be expensive (patients must be rich, or insurance companies or the government must pay a lot for health care). But some people can’t afford insurance or expensive medical care. If doctors earn a lower salary, then more people can afford medical care, and this lets the government (or medical/insurance companies) spend more money on research. Talk about the good and bad aspects of a high/low salary. Also talk about who should pay for medical care: the patient, the patient’s workplace, insurance companies (can poor people afford insurance?), local government, federal government, or someone else?

10. Once you are a doctor, would you rather work at a busy public hospital or at an expensive private hospital? Explain your answer.


Extra questions:

11. Did you understand the sarcasm in this show? Dr. House uses sarcasm a lot. Why? Do people use a similar form of speech when they talk in Chinese?

12. At one point, Dr. House makes an educated guess about the patient’s problem and starts treating it with steroids. Do you think this was a good or bad decision? Explain.

13. Look at dialog 1. Is “fatigue” a kind of pain? What about the patient’s other symptoms—are they “pain”? Explain.

14. Let’s think of pain as both physical and emotional. What effect does pain have on the people in this show? Talk about each person: Dr. Foreman—the pain of being hired for strange (and maybe prejudiced) reasons; Dr. House—a constant physical pain in his thigh muscle; the main patient—physical and emotional pain; the male patient—fatigue, headaches, etc.

15. Can pain be an excuse for bad behavior? Should it be? Why or why not?

16. At one point, the patient decided that she didn’t want any more treatment (she just wanted to die). Are patients in China allowed to make this kind of decision? What do you think about her attitude? What would you say to her, if you were her doctor.

17. This show mentions an “HMO.” These organizations help make medical care affordable in the US, but doctors don’t like them. Can you guess why?

18. If there is a contradiction between your answers to questions 9 and 10 (e.g., “the government should pay” but you want to work at a private hospital), explain why.


Extra exercise:

Make up sentences with some of the phrases and medical terms in this lesson.


Notes: These dialogs have been changed for educational purposes. This isn’t a transcript of the show!

To understand some of the medical terms I looked at or

*I want students to learn these terms (i.e., all of the phrases, plus a few medical terms)

See our Website Standards and Use Policy regarding the sources of definitions used on this website.


This resource was created for our students under our understanding of "fair use" for educational resources. 

This page does not imply any consent from or relationship with the publisher(s) or producer(s). 

2007 As far as I am concerned, people are allowed to print/copy it for personal or classroom use.

 (see Website Standards and Use Policy)


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