Dr. Gregory House had graced us with his arrogance, narcissism, and wittiness from 2004, up until his “death” (or lack thereof) in 2012. You may remember House for his Vicodin addiction and the cane he used to move around, but sometimes it’s a bit challenging to recollect all the details behind his famous leg injury.
*Warning: Spoilers ahead!*
So, what happened to House’s leg? The short answer is that he suffered from a limb infarction during a golf game, This infarction was diagnosed by Dr. House himself upon seeing that his condition worsened and that doctors were unable to come up with a correct assessment of the situation. It got so bad that amputation was suggested as the best solution, one that House refused to accept.
In this article, we’ll take a closer look at what happened to Dr. House’s leg, how this diagnosis corresponds to reality, and other assorted details related to the show and its iconic protagonist.
Who’s Dr. House?
For those who are not familiar with the show, Dr. House is the main character of the House MD series that aired from 2004 to 2012, with a total of 177 episodes broadcast over the span of eight seasons. The series finale aired on May 21, 2012, with no rebooting plans yet on the horizon (as of this writing at least).
Gregory House is touted as being the “medical version of Sherlock Holmes”, blending proficiency in logical reasoning and observation with misanthropy, bluntness, and a general lack of empathy. Some people would aptly describe him as an antihero, that is, a protagonist whose personality traits don’t fit the conventions of what a hero is supposed to be like.
House is also renowned for solving cases in ways that defy medical standards and even ethics. His unorthodox troubleshooting skills, at times, worked in his favour but, at others, earned him disdain from peers. His ingenuity in bringing people back to health (which at times involved taking more risks than necessary) got tainted by the general behaviour he displayed towards patients and colleagues.
What Happened to House’s Leg?
Details about his leg dysfunction will be disclosed in Season 1, Episode 21 titled “Three Stories”. Before that, not much could be ascertained (not surprisingly so). If there was one thing that characterized House was his inability to communicate personal life issues to even his best friend (Dr. Wilson) or his love interest (Dr. Cuddy).
In the aforementioned episode, we see House attempting to tell a group of medical students about a number of cases he worked on. One of these cases turned out to be his own.
We already summarized the circumstances that led to his disability, but we’ll proceed to explain them in more detail:
It all started five years before the events portrayed on the show. He was playing golf when he started feeling pain in his right leg. This intense pain turned out to be a result of a leg infarction. An MRI had revealed what appeared to be a congenital aneurysm – an abnormal bulge in the blood vessel – that got clotted, causing intense thigh pain and, ultimately, gangrene.
What is an infarction?
Infarction is basically tissue death (also called necrosis) due to blood supply failure. This failure could be attributed to a variety of reasons, but the most common are blood clots (thrombosis/embolism) or narrowing of the blood vessels supplying the area [1].
You’ve surely heard of heart attacks. They’re a very standard cause of death among the older population. A heart attack is actually a type of infarction, called “myocardial infarction”. A heart attack is, hence, the death of the heart muscle owing to insufficient or obstructed blood flow.
In the case of House, the infarction occurred at the limb level. The amount of dead tissue was so overwhelmingly high in his thigh muscles that amputation seemed like the best option. However, he opted for an alternative, less conventional route.
How did Dr. House treat his leg?
House began looking into gene transfer clinical trials in an attempt to salvage his leg, enrolling in experimental treatments devoid of FDA (Food & Drug Administration) and EMA (European Medicines Agency) approval.
He then underwent a high-risk surgery that involved having the arteries in the thigh area bypass the dead tissue, restoring circulation to the living tissue. The pain he had to endure during the recovery process was so acute that, at one point, he had to be put into a medically induced coma to cope with the most painful phases.
In the end, House had to resort to a lifelong commitment to Vicodin to ease the daily pain that ensued, to the point of becoming addicted to this med.
It’s debated by fans of the series whether this had any toll on his mental health, contributing to his overall toxic demeanour. Throughout the series, though, we learn that the framework of his character was not entirely different before his leg problem, as was testified by Stacy (his lover at the time of the infarction) and Cuddy. Regardless, the psychological and psychiatric effects of chronic pain [1] and opioid dependence [3] should not be understated.
Was Dr. House’s leg condition realistic?
The production of House MD had a medical staff that would validate most of the technical aspects of the show’s content. This would work at times, though the scientific accuracy of some segments would still be hotly debated among the medical community.
The case of Dr. House is very peculiar since infarction of skeletal muscles is a rare phenomenon and, ordinarily, it would result from chronic sickle-cell anaemia or diabetes, underlying conditions that Greg didn’t seem to have.
Therefore, it would be reasonable to expect physicians to misdiagnose his illness upon first examination, given House’s clinical records not hinting at that possibility. However, we would not dare say that this constitutes a totally implausible scenario, however uncommon it might be.
References
[1] The pathogenesis of arterial embolism: https://vascular-endovascular-therapy.imedpub.com/the-pathogenesis-and-diagnostics-of-arterial-embolism.php
[2] Psychiatric aspects of chronic pain: https://www.ncbi.nlm.nih.gov/books/NBK219250/
[3] Opioid use disorder: https://www.psychiatry.org/patients-families/addiction/opioid-use-disorder
