The news that Lisa Edelstein is quitting House is a tragedy for people who want to see more hot Jews and competent administrators in our mass media. Our popular culture, particularly our procedural shows, are heavily skewed towards storylines where our Slightly Rebellious Heroes Tell The Administrator To Shove It And Save Lives, usually by continuing to investigate crimes or treat patients. Usually, the immediate supervisors of those Slightly Rebellious Heroes are on their side, rather than on the side of the higher-ups. We have very few shows where the administrator saying no is a sympathetic figure, much less a romantic or heroic one. Cuddy was the very rare exception.
That said, part of the reason Cuddy gets to be a Hero Administrator to the audience is that she knuckles under to House his team pretty regularly. Unless she thinks she’s getting a career $100 million value out of House (plus the $50,000 she’s built into the annual budget to defend him from lawsuits), blowing up a relationship with a major donor to defend his continued employment may not have been such a great call. Also, unless Princeton-Plainsboro Teaching Hospital is in every other area of practice the single most efficient hospital on the planet, House’s team must drive up average health care costs like crazy, much of it spent on testing and treatment that lead absolutely nowhere because, as we all know, diagnostic insights arrive as bolts out of the blue. Atul Gawande would probably tell Cuddy to fire House and invest in a really good preventative care program. But in the world of television, if she followed his advice, Cuddy would just be another evil bureaucrat.
To a certain extent, Cuddy’s behavior is fairly realistic. As that Gawande article points out, hospitals have strong incentives to order as many tests and as many procedures as possible totally irrespective of how much they actually improve patients’ health. And it may be that House is part of a larger cycle: some folks have theorized that the show contributes to patients’ desire for heroic care and more tests and procedures. I’m glad we had an image of a smart, savvy, sympathetic woman administrator on television for as long as we did. I just wish she was a hero for advocating for things that were actually good for us.