House's lupus diagnoses ended up becoming a running joke throughout the series, with its titular character, played by Hugh Laurie, often jumping to conclusions about diagnoses by mentioning the autoimmune disease. However, every time he diagnosed a patient with the disease at the start, it ended up being a different culprit. That was until season 4, episode 8, "You Don't Want to Know," when a patient was finally diagnosed with lupus for the first time.

Speaking with Entertainment Weekly, Shore explained the reason behind House always initially diagnosing patients with lupus, revealing it was the most constant serious disease mentioned in medical papers. The showrunner explained its commonalities with other serious diseases, leading to the diagnosis becoming a running gag on the show. He also revealed the importance of actually having it happen once to finally pay off the joke. Check out what Shore had to say below:

[Laughs] It's funny, actually — I ed some papers from early on in the show to the Writers Guild Foundation Library, and I happened to be in there, and somebody happened to be going through them, so I said hi to the person. And I looked at the papers and it was an early script, and there's a reference to lupus in it, and I'd written in the margin, my notes to the writer, "We're running out of diseases already," or something like that. Because apparently it was the second or third or fourth time we'd mentioned lupus.

The fact was we were looking for diseases that could be serious but could manifest in a lot of different ways. And unfortunately for many — for us, it was fortunate, lupus was the perfect disease for us! It was a disease that manifested in a lot of ways, and so it could be the wrong diagnosis many times. And so we just kind of embraced that and ran with that.

[Laughs] It's never lupus. We had a t-shirt that said, "It's never lupus."

This is when I realized it is 20 years ago, and I can't recall the details. I suspect yes, we had an internal discussion about that, "Yeah, I guess we have to do it once." We set up, "it's never lupus, it's never lupus," now we have to make it lupus.

What Shore's Statement Says About House's Constant Lupus Diagnoses

The Disease Has Similarities To Many Other Illnesses

Lupus has many symptoms similar to other diseases, such as rheumatoid arthritis, fibromyalgia, and even celiac disease. However, the seriousness of the medical drama's recurring disease comes from how it attacks tissues in the body, resulting in permanent damage to the skin and internal organs. An estimated 1.5 million Americans and 5 million people worldwide have the disease. However, much like some of House's best episodes sometimes do, the show leans into the disease in a darkly comedic way, making it into a running gag because of how uncommon it actually is.

The fact only one patient across the whole show was ever diagnosed with lupus allowed the joke to reach a climactic point, while also providing information about how the disease can actually manifest. Even though it was finally shown on-screen in season 4, the autoimmune disorder was still mentioned plenty of times after, albeit less commonly. But, by the end of House, the show had managed to not only create a joke that became an important element of its identity, but also explored the disease once before ending.

Our Take On House's Lupus Running Gag

It Became Part Of The Series' Identity

Even though a patient did end up having lupus on the show, House embracing the disease as a running gag emphasizes the dark humor associated with the series. But it also served to explain how it can manifest in so many different forms, becoming a classic part of the show while also being informative for audiences. Shore's explanation clarifies plenty about why it was continually used, highlighting how it managed to become a key part of the series' history.

Source: EW