House, MD is the creative property of David Shore and Bryan Singer. I just like to write expository fiction.

In Legalese: This non-profit work of fanfiction, being neither prescriptive nor anything approaching "sound medical advice," is for entertainment purposes only.

In English: While its author is a real-life medical professional, this is just a piece of fan fiction. Mistaking the literary guidance herein for actual medical advice may result in extreme illness and/or injury. If you or someone you know currently is or might be suffering from symptoms related to an actual illness and/or injury, please call 9-1-1 immediately after reading this story.

How to Write Believable House Fanfic (by Someone Who's Never Tried)

Ever wanted to write a really killer House M.D. fanfic, but didn't know where to begin? Well, my friend, today's your lucky day. Salvation is only a few paragraphs away. Even if you've seen only a handful of episodes, have no medical background and can't find Princeton with GPS, fear not! After reading this, even you will have acquired the basic skills necessary to write your very own (and very-nearly believable) fanfiction chronicling the antics of TV's most irascible, pill-popping diagnostician. Ready? Let's begin!

The first thing you need to know is this: pattern recognition is the key to writing a good House fanfic (or any fanfic, for that matter). Right now, you're probably scratching your head and wondering, 'Pattern recognition? You mean, like, the difference between stripes and plaid?'

Not quite, but glad you asked. See, all TV show episodes follow a simple plot algorithm from beginning to end. Think of it as a kind of story-telling formula or flowchart—a code, if you prefer. Besides providing predictable plot pathways, these series-specific approaches to storytelling also help you identify whether you've just tuned into House or the latest rerun of CSI (which is a perfectly honest mistake, since both Greg and Gil are doctors with antisocial tendencies, both have–or have had–physical/emotional disabilities, and both like bugs. Besides, both of their names start with the letter G). All you have to do is crack the algorithmic code and your fanfic will practically write itself. It's really that simple!

'Oh, sure,' you might be saying right now. 'It looks great on paper, but I watched the season rerun marathon all weekend and I didn't see any of those algo-thingees. There was an eye chart in the clinic, was that one?'

Uh, no. Relax, I'll get to it. But if the above encounter with such polysyllabic gems such as algorithm and antisocial has left you feeling a little wobbly, then you might want to lie down for this next bit of bad news:

Big words: they're your future. Get used to them.

Medical terminology is something you'll have to develop a passing familiarity with if you're going to use it credibly in your fan fiction. Stop whimpering! Once you get the hang of all those Greek and Latin roots, it's a blast and a half, especially if you use it humerus-ly. Doctors only invented medical terminology because they wanted to sound smarter than their patients (seriously, that's a bonafide piece of medical history. I'm not just a-fibrillatin' you).

Try it: pick an ominous-sounding word and then, stick an itis, oma, or opathy at the end of it, indicating that it's an infection, a form of cancer or a degenerative nerve-related something-or-other. Whichever one you choose, just make it sufficiently scary. Remember, people fear what they don't understand, so use their fear to your advantage. Writing about medicine is like writing science fiction… only in medific, the aliens politely ask you to bend over and cough before they stick stuff in you.

Usually.

Feeling better? Good! Now, let's get to the meat and bones of this thing: the algorithm.

Your story should begin outside the hospital. Miles and miles away and ideally, in a crowd, a normal, healthy-looking young person drops like a rock for no apparent reason. Why a young person? Because most fanfic readers are young, healthy folks; and old people, besides being boring, are just going to die anyway. You want readers to identify with the character and believe something awful like that could happen to them. Work that fear factor and you'll have 'em hooked from the start! See? Your first chapter's just written itself!

In your next chapter, House and the gang must argue about what could have caused this baffling case of drop-like-a rock-itis, while the patient languishes at least two floors away in the ICU.

Yes, the ICU.

Not the ER.

Never the ER. That's fodder for another fandom. Do you even watch this series? True fans of House know that the Princeton-Plainsboro Teaching Hospital has no Emergency Department (except for that one episode where Allison was sent to the speshul hell as a form of punishment). Repeat: No. Emergency. Department. It's nothing but a social dumping ground and nothing important ever happens down there. Who cares about the huddled, snot-nosed masses with their strains, sprains, and chest pains! Besides, the average fanfic reader probably visits his or her local ER at least once a week for migraines and whathaveyou, so there's no fear there.

If you have to be task-minded, then have one of the junior diagnosticians declare: "We need to get a CBC, a metabolic panel, and two sets of blood cultures, STAT!"' Make it Dr. Chase. He's cute and has a cool accent. Though all these things sound mysterious and intimidating, most of them are routine tests (ones that should have been ordered for your patient in the ER had there been an actual ER, which there was not). Plus, drawing blood requires needles—long, sharp, evil-looking needles. Unless your readers shoot heroin or are covered in tattoos, no one in their right mind likes needles.

Write that down. Congratulations, you've just cranked up the fear another notch!

When the results of those tests are in, write yourself another round of bickering, ending with House popping a Vicodin, and then saying something like, "It's an infection. Get a CT scan," and you'll be all ready to move on to chapter three.

This next chapter should focus on character development, which will allow your readers to become better acquainted with the hapless patient they all identified with back at the beginning of your piece. Make his or her character interesting, but not too loveable, sympathetic or beautiful.

Why? Because perfect people suck, and your readers need imperfect characters so they can feel better about themselves (fan fiction's a tremendous responsibility. Are you sure you're ready for it?).

By now, your patient's getting a CT Scan. Keep in mind that even though the Princeton-Plainsboro Teaching Hospital (PPTH) has at least one Open CT Scanner in its labyrinthine complex, this donut-shaped apparatus is usually located in a cramped dark room somewhere near the (non-existent) ED: a.k.a., the basement. Also, keep in mind that many of your readers may suffer from nyctophobia, claustrophobia, or groundfloorophobia, so be sure to work it.

During chapter three, the following must occur: the patient's character says something personally revealing, something ultimately relevant to their final diagnosis, only no one will catch it at the time. This in turn must trigger a panic attack, the likes of which a boatload of Xanax can't cure, one that the House-wannabes make worse instead of better, because at least two of them have been fiddling with the scanner's panel of winky-blinky lights or bickering about their love lives instead of paying attention to their patients. Med students, bah!

Where's a real CT Tech when you need one? Or for that matter, a nurse?

Please note that if the PPTH were a real hospital, then only certified technicians would operate its equipment while a nurse attended the patient. In a realhospital, the aforementioned are valued and visible members of a multidisciplinary team. But since the PPTH isn't real and nobody in Hollywood gives a rat's ass about ancillary personnel (especially nurses, unless they're naked), your intrepid Residents must perform every single diagnostic test and invasive procedure all by themselves.

No wonder so many things go wrong!

Which brings us to the last, must-have story element in this chapter. Your patient, who, if you remember, was panicking, begins to either

(a) vomit buckets of bright red blood

or

(b) complain of acute abdominal cramps, after which, s/he exhibits profuse rectal hemorrhaging. For those of you still struggling with medical terminology, the lay term for profuse rectal hemorrhaging is bloody shit storm which, besides being just bloody awful, scares the pants off people and therefore, is bloody perfect.

Bonus if Dr. House insists that it's just an infection, all his colleagues are idiots and nobody ever appreciates his obvious genius.

Knock back a handful of Vicodin with a shot of bourbon. Repeat.

Chapters four, five, and possibly six will follow much the same template as chapter three. Just make sure to have the tests become more and more invasive, eventually requiring exploratory surgery. Preferably cranial exploratory surgery because drilling holes in someone's head while they're awake and talking to you is wicked cool! Hey, it worked for Hannibal Lecter...

Feel free to develop scenic tangents. No episode of House is complete without an ethical confrontation with Dr. Cuddy (wherein her breasts figure prominently), mandatory hours in the clinic (wherein House discovers the final diagnosis through contact with an innocuous and anonymous client), a gratuitous air guitar solo or an intense exchange between House and Wilson (wherein all slash writers flail helplessly).

Wherein hell was I going with this?

Oh, right! Just remember to put all this stuff in your fanfic (unless your fanfic is House/Wilson slash. If it is, then you can just ignore this).

All of it.

Completely.

Seriously, who gives a rat's furry butt crack about canon when there's cute-oncologist-on-cripple action (make it hard, fast and deep, just like CPR). No matter what you write, just make sure that House calls himself a cripple at least once in your story.

If all else fails: Pop Vicodin. Snark. Self-pity. Repeat.

Still need a little, extra something to pull it all together? Don't forget to intubate! Remember, your patient has to have at least one near-death experience during their stay. With all the super invasive stuff you've put them through, they're overdue for a Code Blue. Really, they owe you one. This stimulates flagging reader interest, and gives Dr. Foreman something to do besides whining, quitting and lock picking. And because the aforementioned Dr. Foreman's sticking a big plastic tube down someone's throat (preferably, while your patient's dysfunctional family huddles in a dark corner of the room), it's—

Some scaaary shiiiiit, dude! A horror story with malady as the monster!

Never forget the fear factor.

Oh, and don't sweat the details of intubation or of any procedure for that matter. They'll just bog down your prose and bore your reader to death. You're not writing M*A*S*H fanfic, after all (assuming you're even old enough to know what that is). No one gives a hoot about how the procedure is actually performed, what kind of precautions are involved or whether clean vs. sterile technique is required.

Lord knows, the writers and producers of House don't.

Sorry, that was an inside joke for any medical professionals who might be reading this.

Anyhoo… Look! We've made it to the Big Reveal: the final chapter!

After demeaning the nursing staff, Dr. Greg hobbles in to save the day. Your story ends with him having a self-congratulatory cigar and multiple shots of whiskey at bedside (because in New Jersey, every bedside stand is stocked with a bottle of bourbon and a box of cigars. It's a Union thing). Let your patient have a snort, too; he or she's earned it!

See how easy that was? Now publish it, sit back and wait for that avalanche of glowing reviews –especially if you've written hot, sexy House/Wilson PWP!