An und für sich

In the season finale of House, House makes a final effort to convince Foreman, his subordinate whose threat to quit provides the overarching plot of the last portion of the season, to stay on the team. Earlier in the season, Foreman had lost a patient through his own mistake — based on a particularly elegant diagnosis that deeply appealled to House (and to Foreman), but turned out to be incorrect, such that the treatment ended up killing the patient. At this point, Foreman realizes that what he has been trained by House to regard as a kind of game (diagnosis) is in fact a game played “for keeps,” and that he’s been ignoring the actual people involved. Thus he wants to become involved in a “normal” practice where he won’t be forced to use risky procedures in order to solve the extremely unusual cases House’s team normally faces. House decides immediately that he needs to fire Foreman, because Foreman has lost his edge.

The truly decisive moment for Foreman, however, is in a later case when he does regain his edge — due to a complex series of events, two teenage brothers are in a situation where the parents have to make an impossible choice: to save one means allowing the other to die. Foreman comes up with a solution that requires extracting the bone marrow of one of the brothers, even though the brother is so sick that sedating him would endanger his life. Thus Foreman performs the extremely painful procedure without sedation, effectively torturing the boy, but successfully saving both their lives. Believing himself to have acted “like House” (i.e., like a moral monster who submits human need to medical effectiveness), Foreman submits his resignation after the very act that makes House decide that Foreman does indeed have what it takes.

Throughout this season, there had been explicit attention drawn to the deep satisfaction House receives from diagnosing extremely difficult cases — in fact, early in the season, when his colleagues Cuddy and Wilson deprive him of this satisfaction by leading him to believe that he incorrectly diagnosed a man whom he in fact (near-miraculously) brought out of a quasi-vegetative state, House returns to the drug habit he had kicked, triggering the sequence of events that lead to House almost being jailed. In one of the final episodes of the season, Wilson sereptitiously gives House anti-depressants, which means that House’s joy in diagnosis is amplified — House is deeply satisfied with himself for having “called” a diagnosis based on only the most minimal clues, but he ignores the fact that the diagnosis is untreatable and therefore a teenage girl will die. The whole team is scandalized, but for Foreman, it is especially heinous, and basically confirms to him that House is a moral monster.

In the final episode, House manages to save a woman’s life by predicting that she has a heart deformity that has never before been seen — a diagnosis that is extremely satisfying to him. Foreman, on his way out on his last day, confronts House about this, saying that House disgusts him, that it’s all a game to him, and that Foreman does it (or wants to do it) for the sake of the people rather than the intellectual satisfaction. House replies that his enjoyment of his work is irrelevant to his patients, who are just grateful that he saved their life — it’s not House who is simply serving his pride, but Foreman. To put it in quasi-Kantian terms, it is Foreman, with his desire for gratitude from patients, who is pursuing medicine for pathological reasons — House practices medicine solely for the sake of medicine itself.

At this point, we could say that House perfectly embodies Badiou’s ethics of the situation — and in fact, medicine is the prime example that Badiou uses in his Ethics. What House introduces, however, is a Lacanian twist: if medicine is House’s ethical duty, then it must be said that he enjoys doing his duty. Foreman is stuck in the mindset that whatever intellectual satisfaction he gains from diagnosis must be regarded strictly as a “side-effect,” lest his enjoyment somehow pollute the moral rectitude of his practice as a doctor — that is, prevent him from being a doctor who is nonetheless a “real person” underneath.

House confronts him with the basic falsity of his stance. Yes, from the perspective of everyday values, the truly medical man does appear to be a moral monster. The solution, however, is not to pretend that this is not the case, but to fully embrace it in order to be as ruthlessly (in the strict sense of “mercilessly,” as when Foreman submits the patient to extreme pain in order to save the patient’s brother) effective as possible. Only by deriving his enjoyment directly from the medical situation is House able to perform purely and truly as a doctor — everyone else, with their concern for factors that are “pathological” with regard to the medical situation (gratitude of patients, etc.), not only fails to face the moral monstrosity that medicine really is, but also compromises their very medical judgment.

Thus what Foreman can’t stand is not that House is such an evil person, but rather that House is the only “healthy” person in the show’s universe — the only person who is able to enjoy doing his duty. That is to say, what bothers Foreman so much is not House’s indifference to others, his penchant for petty taunts, etc., but House’s profound enjoyment — an enjoyment that he himself shares but won’t face. As House tells him in one episode, Foreman already effectively is like House — and, I would argue, every true doctor is.

This coheres with Zizek’s theory in fairly obvious ways. But what if the figure of House is also like the figure of Zizek (that is, Zizek the man). Zizek often repeats a story of his uneducated relatives asking him how much he makes as a philosopher, with the punch-line that what his relatives really can’t take is the fact that he so obviously enjoys his work. With this in mind, a lot of things fall into place. The repetition — a feature that, impossible as it sounds, is present from the very beginning — wouldn’t be lazy, then: he is fundamentally satisfied with his exposition of a concept, his deployment of a joke, etc., and sees no need to change it the next time it’s appropriate to refer to the same concept. For the average neurotic academic, incessantly revising, getting feedback, holding back from publication out of a sense of unworthiness, it is Zizek’s very confidence in his writings (a confidence that is, to be sure, sometimes misplaced — the oft-repeated “Rabinovich joke,” for example, doesn’t really seem to be well-suited for what he’s using it for) that is so galling. His refusal to provide a concrete political program — that is, his limitation of himself to “provocative” interventions with no clear consequences for policy choices — is not irresponsible, but rather points toward his absolute devotion to the task of philosophy, which as he says is to reconfigure the questions rather than provide answers. His frenetic pace of publication, his (sometimes over-hasty) responses to every academic trend — they demonstrate his love of being involved in academic conversation, also shown by his generous footnoting of people’s ideas that he picked up in private conversation and his consistent practice of making room in every book for extended discussion of new books (and sometimes even new articles) about Hegel or Lacan.

Both for academics who feel guilty for doing academic work instead of “real activism” and for academics who believe that one must take a stance of impersonal detachment in order to produce responsible scholarship, such a figure is clearly intolerable. And thus it would appear that Zizek has succeeded in what Kierkegaard complained that Hegel failed to do: his philosophy also accounts for the contingent author, that is, Zizek himself.

[I'm thinking of going through and watching the seasons of House and working this up into an article -- though perhaps excluding the stuff about Zizek's personality. Please, give me feedback! Tell me what I need to revise! Then I'll post successive drafts and we can do it again!]