As House enters its eighth (and as Laurie says) final season, we look at medical series' and examine what makes them so popular.
Medical dramas still grip audiences worldwide
Given that it was the most watched television programme in the world not so long ago, this week's news that the multi-award-winning medical drama House has been renewed for an eighth season by the American television channel Fox was not, in all honesty, so much of a surprise. But what did make fans of the goings-on at the fictitious PrincetonPlainsboro Teaching Hospital sit up and take note was the prognosis from the star of the show, Hugh Laurie, that it might be the last.
Laurie's portrayal of the crankily brilliant Dr Gregory House has not only won him huge acclaim, but made him significantly wealthy: the 51-year-old is rumoured to be the highest-paid actor on television. But perhaps there's more to Laurie's much-publicised recent foray into blues music (his debut record, Let Them Talk, is out now) than mere fun. Could it be he's already looking forward to a musical career post-House? "The end of [the eighth] season, right now, looks like the end of the show," he told the British magazine Radio Times. "That is as far as they have got me for."
And while the default position of television networks is to be loath to commit to recommissioning series more than a season in advance, Laurie has clearly been thinking about the end. "When the time comes, I think it would be good to have sort of a clean finish rather than just sort of trailing off," he said. "I'd like to go out with a bang, not a whimper."
Whatever the future for House's department of diagnostic medicine, one thing is certain: it won't be long before there's another hit medical drama to replace it. Right back to Dr Kildare - an American television show that premiered in 1961 but had previously been a film and radio series - some of the most successful and popular television shows of all time have been set in hospitals.
It's obvious why: the medical profession - which deals with heart-pounding life-and-death situations every day of the week - is inherently dramatic. It feels more realistic, too: while it's faintly ridiculous for an ongoing cop show in a small town to revolve around murder after murder, people are always being rushed to hospital.
What's interesting is that, in medical dramas, they don't always survive. But such unhappy endings still make great television because they connect with something more cerebral: illness and death are something we're all scared of but watching them happen on screen - and enjoying the experience - allows us to deal with them in a way that doesn't affect us.
It's no coincidence, either, that the most popular medical dramas have strong protagonists. In a way, they're a form of hero worship - Dr Kildare and the 1962 British drama Dr Finlay's Casebook even put the heroes in their titles. The latter was interesting because, although it was set in a medical practice in the fictitious Scottish town of Tannochbrae, the series increasingly became a soap opera in form, much to the chagrin of Dr Finlay's original creator, AJ Cronin. The purity of the original idea might have been damaged, but every medical drama since has had some element of soap to it. In fact, Grey's Anatomy - charting the lives of young interns and physicians at Seattle Grace Mercy West Hospital - has steadily become distanced from the actual medical care at the institution.
Still, the likes of M*A*S*H proved that the working lives of medics are easily moulded into lighter forms of drama. Set in the Korean War at a Mobile Army Surgical Hospital (hence the acronym), it began life in the 1970s as a straight comedy - the first series even had a laughter track. But as the years passed, the canned laughter diminished, to the point where episodes became more overtly political and thoughtful: the Korean setting being a cipher for the ongoing Vietnam War.
The chief surgeon Hawkeye, played with a twinkle in his eye by Alan Alda, had a pleasingly childish attitude, which was hugely important to the idea of comedy as a coping mechanism in the operating theatre. His friends faced death, his job was to patch up injured soldiers on a daily basis and black humour was the only way to keep going.
And comedy would later be a crucial element of the 21st-century hospital drama Scrubs. An anarchic and surreal series set in Sacred Heart Teaching Hospital and starring Zach Braff, the gags and pace were so fast it ran out of steam and was cancelled last year.
But then, Scrubs had the same problem as any medical drama broadcast after 1994: how to follow ER. It's difficult to believe in 2011, when networks around the world are dotted with medical dramas (South Korea's Surgeon Bong Dal Hee and a Colombian adaptation of Grey's Anatomy, A Corazon Abierto, sound particularly intriguing), but there was a time when the genre was as dead as a less-fortunate patient. The cool, ratings-busting dramas featured cops and gritty crime scenes. It took Michael Crichton - more famous for writing Jurassic Park - to perform CPR on the medical drama.
That wasn't quite as bizarre as it might sound - Crichton had been a medical student himself. And setting the drama in the adrenaline-fuelled rooms of the emergency ward was a masterstroke. It was shouty, the complex, multiple storylines weaved in and out of one another and the jargon was impossible to decipher, but such intensity, combined with almost documentary-style shaky camerawork (later used on House) made it feel like we were being parachuted into the middle of a gripping crisis every week. The personal lives of the characters regularly impacted on their dealings with patients and made them seem human, rather than heroes in white coats. Oh, and ER had George Clooney. It was a long, long way from Dr Kildare or Dr Finlay's Casebook.
And the world loved it. There are longer-running medical dramas: Casualty in the UK has been going since 1986, despite an unchanging format which has been mocked mercilessly over the years. But, even though Casualty can boast the at-the-time unknowns Kate Winslet, Minnie Driver, Orlando Bloom and Sadie Frost among its injured, bleeding stars, ER has always been classier and, well, more exciting.
Of course, it's not just the hospitals of the UK and the US that have proved enthralling. Australia brought us the notably melodramatic The Young Doctors in 1976 and the slightly more considered Flying Doctors in 1986. Hospital Central is famous throughout the Spanish-speaking world (although it is, admittedly, rather an obvious homage to ER).
Indeed, the race is always on to find the next ER. In terms of ratings, it's undeniably been House, although they are very different beasts. Nurse Jackie is steadily picking up an audience for its comedic look at life in a New York hospital (the anti-hero Jackie appears saintly to her patients but in fact is struggling to keep her life together), and is now into series three - although the irreverence and 30-minute format mean it is unlikely to become a real crossover hit. Grey's Anatomy - which, five years ago, was proper appointment-to-view television - has somewhat stumbled into a seventh season (the finale is next week). Last year, Jerry Bruckheimer tried to do for trauma doctors what he did for Crime Scene Investigators, but Miami Medical was cancelled after a solitary season. Meanwhile, most of the plaudits have gone to a programme with not a scalpel in sight. In Treatment follows the sessions that the psychotherapist Dr Paul Weston has with his patients - but even that show probably won't continue beyond its third season.
House, then, is still the meatiest, most satisfying medical drama of the 21st century. So you wouldn't bet against Laurie coming back one last time, despite his protestations to the contrary.
After all, if Gregory House does have a catchphrase, it's "everybody lies".