House, MD and the whiteboard syndrome

In my ongoing efforts to catch up to popular culture, I’ve taken to watching the first season of the TV program House, MD. Once I reached the last episode, I decided to do something I normally don’t, which is what the special features. That’s when I learned about the show’s surprising white board upgrade cycle.

For the uninitiated, House MD focuses on a team of doctors who specialize in diagnostic medicine. When a patient comes in with a condition that seems untreatable, the lead character and his staff spend much of each episode using their powers of deduction to experiment with an appropriate treatment. As part of this process they make frequent use of a white board, where potential conditions, drugs or symptoms are routinely scrawled, just in the way companies use white boards to brainstorm better business strategies.

In a behind-the-scenes featurette the DVD provided, one of the actors mentioned that they were now, in fact, on their fourth white board. The first one was large and almost square, but was too shaky. Then they moved to one that proved difficult to erase. They got all fancy with a white board that was transparent (like the ones TV weathermen of yesteryear used to use) and have since gone back to a more traditional model.

As a viewer – and one who watched the entire first season without the distractions of other TV shows, no less – I have to confess that I never noticed. What you focus on when you watch house is the medical detective work, the way they bounce ideas off each other until they hit upon the cure that would elude all other health-care professionals.

Later, I realized that for all the upgrades, the characters on the show never seem to go beyond the white board to collaborate or exchange ideas. They walk around with pagers instead of a device where they might share inspiration as it comes to them. There’s no social network online where they might tap into the collected expertise of their colleagues online in other hospitals. Despite in actually investing in a centre for diagnostic medicine, I highly doubt this (admittedly fictional) organization) has ever considered creating a data warehouse or other repository where they might record more information on their casework so as to more easily identify the conditions of future patients.

Of course, these things would make for much less compelling TV, but it goes to show how manual and offline problem solving can be, even among highly intelligent problem-solvers. Although there are electronic versions, white boards are for the most part disposable knowledge management systems. Maybe with the right advancements in technology – I’m thinking specifically of tablet or surface computing – we might one day see the kind of replacement that could better capture and organize the kind of free-flowing information that experts like the characters on House commit to white boards (and then cross off). The title character probably wouldn’t like that idea, but real information work sometimes requires strong medicine.

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