Pilot (House)

"Pilot", also known as "Everybody Lies", is the pilot episode of the medical drama House. It premiered on the Fox network on November 16, 2004. It introduces the character of managerial, antisocial Dr. Gregory House (played by Hugh Laurie) and his team of diagnosticians at the fictional Princeton-Plainsboro Teaching Hospital in New Jersey. The episode features House's attempts to diagnose a kindergarten teacher after she collapses in class.

House was created by David Shore, who got the idea for the misanthropic title character from a doctor's visit. Initially, producer Bryan Singer wanted an American to play House, but British actor Hugh Laurie's audition convinced him that a foreign actor could play the role. Shore wrote House as a character with parallels to Sherlock Holmes—both are drug users, blunt, and close to being friendless. The show's producers wanted House disabled in some way and gave the character a damaged leg arising from an improper diagnosis.

The episode received generally positive reviews; the character of House was widely noted as a unique aspect of the episode and series, though some reviewers believed that such a cruel character would not be tolerated in real life. Other complaints with the episode included stereotyped supporting characters and an implausible premise. The initial broadcast of "Pilot" was watched by approximately seven million viewers, making it the 62nd-most-watched show of the week.

Shortly after the start of class, kindergarten teacher Rebecca Adler becomes dysphasic and experiences seizures. Dr. James Wilson attempts to convince Gregory House to treat Adler (who Wilson claims is his cousin), but House initially dismisses him, believing that the case would be boring. Hospital administrator Dr. Lisa Cuddy approaches House in the elevator and attempts to persuade him to fulfill his duties at the hospital's walk-in clinic. House refuses, claiming that Cuddy cannot fire him due to tenure, and hurriedly leaves. When House's team attempts to perform an MRI on Adler, they discover that House's authorization for diagnostics has been revoked; Cuddy restores his authorization in exchange for his working at the clinic.

Adler's throat closes up during the MRI due to an allergic reaction to gadolinium, prompting two members of House's team, Dr. Robert Chase (Jesse Spencer) and Dr. Allison Cameron (Jennifer Morrison), to perform a tracheotomy. In the hospital's clinic, House's first patient is a man who is orange because of an over-consumption of carrots and vitamins (niacin). House also treats a ten-year-old boy whose mother allows him to use his asthmatic inhaler only intermittently instead of daily as prescribed. House criticizes the mother for making such a drastic medical decision without first learning more about asthma. During his monologue, House stumbles on an idea and leaves quickly to treat Adler; he diagnoses her with cerebral vasculitis, despite having no proof. House treats Adler with steroids, which improves her condition greatly for a time, until she starts seizing and has heart failure.

On House's insistence, neurologist Dr. Eric Foreman and Cameron break into Adler's house to find anything that might account for Adler's symptoms. They find an opened package of ham in Adler's kitchen and House concludes that she is suffering from neurocysticercosis from eating undercooked pork at some point in her past. Adler refuses to accept more random treatments unless there is conclusive evidence that the diagnosis is correct. House is ready to dismiss the case when Chase provides an idea for noninvasive evidence of Adler's tapeworm infection. By taking an X-ray of her thigh, House proves that Adler is infested with other tapeworms and her condition is treatable. After seeing the evidence, Adler agrees to take medication to kill the tapeworms. Adler is then visited by her kindergarten class upon her recovery.

In 2003, executive producers Katie Jacobs and Paul Attanasio approached David Shore about developing a series with them. Attanasio, inspired by the "Diagnosis" column in The New York Times Magazine, suggested a medical-themed procedural. Shore was initially not eager about the medical focus, but found the networks they pitched to were interested in the concept. The trio pitched House to the Fox Broadcasting Company as a medical detective show—a hospital whodunit where the doctors would be the sleuths looking for the source of symptoms. The ideas behind House's character were added after Fox bought the show. Shore was inspired by a vivid memory of a doctor's visit: he once had to wait two weeks to get a doctor's appointment for a sore hip, by which point his pain had disappeared. Nevertheless, he went to the appointment, and Shore recalled thinking they were "incredibly polite" even as he wasted their time; he liked the idea of a doctor who would have been blunt with their patient. Shore said that the writings of Berton Roueché, a The New Yorker staff writer who chronicled intriguing medical cases, inspired the plots for "Pilot" and other early episodes.

As Shore developed an outline for the show, he was afraid it was developing into a more character-focused series, rather than a procedural. Attanasio suggested not showing the network an outline, and instead giving them a full pilot script. The pilot took Shore five months to write, and the completed script was delivered in early 2004. Shore recalled there were relatively few changes to what he wrote; one significant change was moving the setting from Boston to Princeton. Director Bryan Singer suggested the change because he had grown up in Princeton and liked the smaller, more academic-focused setting that was more unique on television.