Thursday, February 10, 2011

Pardon the Interruption: House 7:11 - Family Practice

Overall Rating: 10.0

WOW!! So many amazing things happened this week that I can hardly know where to start with the praises. This is a must-see even above and beyond "Broken" or "Three Stories" and in the same neighborhood as "House's Head / Wilson's Heart."

(Note from Stephanie S.: Usually, we write joint reviews for the best episodes, but I'm going to have to sit this one out. SABR Matt's commentary is so thorough that I have absolutely nothing to add.)

Plot Synopsis:

PotW: House's team is unwillingly dragged into a very personal case when Cuddy's mother turns up in the ER with an irregular heart beat and a myriad list of other minor (seemingly unrelated) complaints and starts demanding the best of treatment. Because Cuddy trusts House's medical judgment above and beyond anyone else, she ignores the obvious ethical and emotional consequences of getting him involved and shoe-horns him into the game. When he treats her mystery like any other, she fires him for being an ass, but Cuddy won't let him off the case. Insted she orders him to shadow another primary physician who performs the usual (competent but unimaginative) series of tests and makes the usual diagnoses. Unfortunately, House thinks the usual diagnoses will lead to her untimely death, he's got another opinion about her condition.

He thinks, rather than an auto-immune condition requiring Prednozone, that she's got endocarditis - an infection of the heart muscle. He orders his unwilling team to switch her meds to broad spectrum antibiotics and she has a bad allergic reaction (which confuses her attending, who thinks she's somehow allergic to Prednozone). Having seen this apparent symptom, the other guy concludes that she's got a bacterial infection...but now House thinks she's got a fungal infection in her has to switch her meds again or she'll die. This time, his team outright refuses to participate and he takes it up with Cuddy, who'd told him to do whatever it takes to treat her mother and leave her out of it. She is stunned by his proposal - it's not just unethical, it's illegal and they all risk their licenses. She nonetheless agrees to switch the meds, but House's most moral underling (Masters) reports everything to the other attending and he threatens to go right past the Hospital board to the state medical ethics review board.

Having heard all of this, Cuddy's mother decides she wants to get the hell out of PPTH and Cuddy backs down, allowing her to leave. Of course, this infuriates House, who calls Cuddy on her cowardice and explains the reasons that it affects him so greatly. (Highlighted below) With renewed courage, Cuddy makes an impassioned plea that her mother should trust her medical judgment and threatens to slash the tires of every ambulance in the ER bay to keep her there, and her mother relents, allowing House to return as her primary physician. Her heart rate skyrockets again while House is examining her and he has the breakthrough - he realizes that she's still being poisoned (an early potential diagnosis) and cuts into her leg, revealing that her surgically implanted hip joint has corroded and is leaking cobalt into her blood. They remove the joint and save her life...just in time.

GO Masters GO: Masters - the Cameron that Cameron should have been! - proves early in the case that she "can't be trusted" to do things House's way by complaining when House bugs Cuddy's mother's room. As such, House decides that his team will be "off the case" and leads them to a coma patient's room. He asks them for a DDX on the coma patient's condition and Masters comes up with a good theory (while House very carefully avoids saying anything at all to influence them) and he simply nods when she suggests doing some simple blood tests. But all of this is a rouse. As it turns out, House found this patient because he wnated someone with a "no treatment without consent" order so that he could blackmail Masters into keeping her mouth shut when the time came.

And come it does. WHen she inevitably realizes the game that's being played and reports it to Cuddy (who already knows that underhanded things are afoot, but does not know the specifics), House asks everyone to leave Cuddy's office and drops the bombshell. If she does not keep her mouth shut, he will report her violation of Federal law (intentional or not) to the board and destroy her career. This bastardly maneuvering drives her to the porcelain throne in disgust, but, showing incredible courage, she nonetheless tells Cuddy's mother and her attending about the drug-switches and prepares for the boom to drop. Even more unbelievably, House is so moved by her display of morality, courage, and conviction that he decides not to scuttle her career or fire her. He says in no uncertain terms that he needs someone like her to keep him from doing something that will eventually hurt Cuddy (!!).

Taub's Soul: Continuing from the theme from two episodes ago, we find Taub questioning whether he is a terrible person as he moves out of his house and into a cheap motel. His financial problems drive him to consider taking a part time medical consulting job with his ex-wife's brother (who hates him, BTW, for cheating on his sister...and treats him like scum at his interview), but when he discovers that a boy who was hit by a car (a case that's about to close) might have a small bleed in his brain that could kill him, he breaks the law, violates confidentiality, damages his ex-wife's brother's law practice...all to be absolutely certain that the kid is in no danger with a contrast MRI. The results prove that the boy is fine and our lawyer "friend" shows up to beat the crap out of Taub, calling him a failure. He's convinced he is in fact a failure and sulking in his motel room when his ex shows up and tells him that although he was a lousy husband, she believes he's still a good man - and it's things like this that prove it.

The Skinny:

I can honestly say, when Cuddy's mother appeared in the clinic, I did not see this kind of high impact storytelling coming. The patient/mystery story is usually best when it has a personal impact on one of the main characters...or in this case...on almost ALL of them. Interestingly, House's games did NOT include Wilson this time around, perhaps because this particular patient was too important to waste much time trading barbs that might lead to the answer, or perhaps because Wilson's been a bit of a pain in the ass lately (though that's not entirely his fault) and might make things harder, not easier. But...without Wilson as his crutch, House does four (count 'em!) things that take a sort of courage and humility that we've not really seen from him in the past.

  1. He has the foresight not to take a potentially interesting case (although he protests that he doesn't believe the case is interesting) because (and this admission is explicit) he's too close to Cuddy to be objective about her mother's care.
  2. Despite the impact that the same kind of duplicity had on their relationship a few weeks ago, he chooses to do everything in his power (including illegal things) to get Cuddy's mother the best treatment he can...his team even calls him on the source of this unusually aggressive (and dangerous) decision making. He cares about Cuddy too much to be objective.
  3. He is able to stop playing games and admit to Cuddy that her refusal to confront her mother for the way she treats her angers him so much because some day, he thinks, she'll come around to the idea that the criticism is House's fault (he says she'll blame him for her mother's impending death, but more is implied here and House gives specific examples).
  4. And yet, despite all of the underhanded things he does to save Cuddy's mother (a zeal that comes out of love, rather than just a passion for the puzzle), he is able to finally admit that he needs someone on his team who has the courage to stand up to him when he's being immoral...and he needs Masters specifically to protect him from hurting Cuddy.
HE CAN BE TAUGHT!!! This is the kind of hope I've been waiting for for SEVEN years. Every once in a while, they do an episode where House is forced to admit that his rigid, bleak world view might have limitations, but I don't think we've ever come so far that House is willing to admit that morality isn't just an invention to control human behavior or a crutch for the intellectual coward or simpleton. I can't recall a moment that has the iconic, game-changing resonance of House practically apologizing (and meaning it!) to a moralist like Masters and begging them to stay and keep him grounded.

And it all goes back to a core belief that I very much share with the writers. I dare say my co-author has expressed doubt about it, but as someone who has had his world view somewhat remade by true love, I believe we're seeing a powerful argument for the belief that true love (not the abstract notion in Beetles lyrics, not lust, not a lifelong unfulfilled desire...real, personal love) is the only instrument powerful enough to remake a damaged soul. House has done many noble things (and a few horrible ones) in the name of his long term obsession with Cuddy. Their early (sexual) relationship led to a lot of short term changes in House, but as his dedication to their relationship has he's actually fallen in love with her in a more concrete way...he's suddenly making space for her daughter, tolerating her over-critical mother, and asking for help from his colleagues to keep him from hurting her.

A bit of a personal story is in order here. I started off in a much better place than House, obviously, but, although I had an intellectual ideology that remains basically unchanged to this day, I never really tried to live fully by my own moral standards. I mean, I tried to be a basically good person, but without a personal experience in love, I really didn't know how to give it properly. For example, although I understood on a purely logical level the Catholic Church's argument regarding premarital sex, I disagreed with it because I honestly believed that sex was a prerequisite for falling completely in love with someone. I argued (and my sister will doubtless remember this) that to know whether someone was right for you, you really needed to try everything together and see if the chemistry was there. She used to rebuke that argument with "a person is not a used car that you need to test drive." And today, I am prepared to admit that I had it all backwards. Chemistry does not come from is not "good or bad" based on some biological formula exclusively. Thank God I met someone who was very committed to the idea of waiting and fell in love with her...we had some very basic chemistry (and you can always tell this without having to have sex...the cues are more basic than that), but things have only gotten better the longer we've been together, and this whole process has not only taught me patience but redoubled the strength of my moral core identity and caused me to begin rededicating myself to Catholicism. My experiences over the last year have changed me in other ways...countless ways large and small...and none of it would have happened if I hadn't learned how to love someone.

Back to this episode...I think even Taub is discovering (though he's at the beginning of this journey) that loving someone (even someone he is forced to give up for her own sake) is the crucible by which our morality is forged. When he first arrived, he seemed perfectly comfortable with his "vices" - though any objective observer would identify adultery as not a simple vice but a deep personal failure - but this week, he found the courage to do something completely selfless when the accusation came down from the woman he loved that he was a bad person. Here again, true love is like a beacon's the ones we love that have the most power to shine a light on our shortcomings and give us the desire to change.

This has been a long post, so I'll conclude it here by saying that I've never been more convinced that the writers will handle the Huddy well and that, by the end of this great franchise, we will see House as the same...but fundamentally different and fundamentally happier. What better way is there to end this story than to prove that, no matter what your personality is like, you can find happiness by finding a way to love someone unconditionally - with all of the personal consequences that love carries?

Writing: 10.0

The highlights section will be VERY long this week. This episode simply CRACKLES with dramatic tension and excellence dialogue.

Acting: 10.0

Even the patient of the week (this time, someone more personal) was an outstanding actress, and the subplot filled with outstanding performances, let alone the top notch work done by Laurie, Tamblyn (Masters) and Edelstein. Nothing feels out of place here...nothing.

Message: 10.0

This is not a simplistic cry of "love conquers all"...this is something much better - "True love - properly fueled by personal sacrifice, commitment and selflessness - can unbreak a broken man."


MOM: If you're going to dress like an Italian hooker, at least let it be this year's Italian hooker. (LOL)
CUDDY: Mom...
SIS: She's not saying we look fat...this is a major breakthrough.
MOM: If you didn't want to be insulted, you wouldn't have invited me. (LOL...she's a lot to take, ain't she?)

MOM: Is it connected to my other symptoms?
CUDDY: What other symptoms?
MOM: It's not her fault...this 'Dean of Medicine' thing is impressive at parties, but she's been at it so long, she's forgotten how to be a real doctor. It's all in my file. (Ouch!)
HOUSE: There are fifteen years of clinic visits in this file.
MOM: No offense, but...isn't this exactly what you do for a living?
HOUSE: So...we're looking for a condition that lasts a decade and a half, causes constipation, diarrhea, cold, flu, stiff back, joint pain, heart feeling...weird...kishkas feeling actual hip replacement...and has eluded fifteen years of exams, blood work, X-Rays and MRI scans. Well one thing does pop to mind...
CUDDY: We'll monitor you and we'll give you a thyroid test. And House's team will search your house for environmental toxins.
MOM: He's good...he seems to know his why can't he afford a lab coat that fits? (LOL! Such a Jewish Mother. :) )

TAUB: There is no case. Cuddy doesn't want House to see it, which means she's hiding something in it. Probably related to her being a ginormous high school geek.
MASTERS: Oh, so you'd have some experience with that.
TAUB: Well, no, that's not what I...
MASTERS: high school, I was crowned Homecoming Geek. (makes a very geeky and cute pose...I really like her...LOL) You probably can relate.
TAUB: I was class president and head boy of...OOOWWW!!!! (produces photos from a drawer)
MASTERS: Is that Cuddy's mom?
TAUB: Certain parts of her...and other parts from a very...muscular...Hispanic gentleman who...
MASTERS: Should we be considering sexually transmitted diseases?
TAUB: I think I just caught one looking at these photos. (ROTFL!)

RACHEL: I got you a tryout for a part time legal consulting job...
TAUB: Wait...with your brother?? Have you completely forgotten the last time I saw him?
RACHEL: OK, that was five years ago...and you need this job.
TAUB: Rachel...
RACHEL: OK, he'd just found out that you were cheating on me with your partner's daughter...he was understandably angry and...
TAUB: He broke my nose and then he called me the worst person he'd ever met.
RACHEL: He shouldn't have broken your nose. (OOOOOWCH)

MOM: Look, my right hand just started to shake - it's a side effect of these arthritis pills you gave me - read the label.
HOUSE: I did...when I typed it up. And then slapped it on a bottle of sugar pills.
MOM: You made up a phony label just to prove I'm a hypochondriac?
HOUSE: Did it work?
MOM: It got you fired, you schmuck!
CUDDY: An hour to convince her to go with Dr. Kauffman and only then because he runs internal medicine. She wanted to leave the hospital!
HOUSE: A woman who's getting better wants to leave?
CUDDY: If she's getting better, it's not because you made her feel like an idiot.
HOUSE: It couldn't be more because of that - if I hadn't she'd have diagnosed herself with six new forms of cancer...she'd never leave! (right here, we see another example of Cuddy not standing up for her mother...or more directly, choosing her mother's judgment over House's judgment)

HOUSE: Hey...psst! Come here! (whispered...the rest of his team follows him into his half of the office) DDX. Go.
FOREMAN: We just did it.
HOUSE: We just did the fake one. Now we need to do the real one. Why do you think I let the truth fairy know about the bug? It was a test...she failed. She's still a narc. (in here because it's building to something huge)

CUDDY: Alcoholic?
HOUSE: We're going to have to slip her the pills. The treatment is side-effects...literally just a few vitamins. It won't even interfere with the biopsy Kauffman's running.
CUDDY: I have to ask her about this.
HOUSE: Absolutely. You'll ask...she'll deny'll press her...she'll get upset...and you'll end up right back where you started, only it'll be harder to treat her. You gotta do that.
CUDDY: I don't think she'll lie to me.
HOUSE: She just spent five years going south of the border down Mexico way.
CUDDY: We have our issues, but since Dad died we tell each other the truth when asked directly. It's important to us.
HOUSE: Addicts lie. (and he should know)

CUDDY: If something like that comes up again, just do what you need to do.
HOUSE: And leave you out of it?
CUDDY: Yeah. I am being a coward. Which is exactly why doctors shouldn't treat family members. Congratulations, House. You were usual. (but this isn't logic here...this is still Cuddy afraid to stand up to her mother and wanting to delegate the tough decisions to someone whose judgment she trusts)

CHASE: OK...what disease can turn Cuddy's mom into a 48 year old coma patient named George.
HOUSE: Lupus? (ROTFL!)

TAUB: Am I a horrible person? I used to win awards for volunteer work...I went to Guatemala to fix cleft pallets. Now I'm sitting here letting someone else do my dirty work.
FOREMAN: You're doing the right thing, you're staying out of it.
TAUB: I don't know...I don't know about anything anymore. And then there's this thing with this kid...
FOREMAN: You're doing the right there there too. A: His previous consultants - experts in radiology no less - said no bleed. B: You yourself said it's probably not. C: You signed an NDA so doing anything would be illegal. D: You'll lose your consulting job. E: Your ex would kill you. F: I'm running out of alphabet here.
(enter Chase, looking defeated)
FOREMAN: You do it?
CHASE: I had the bag, I was walking toward the room when Cuddy's sister saw me and said, "Doctor CHase...I met you at the charity benefit last fall." It's gotta be one of you two.
FOREMAN: I met her mother at the same benefit.
TAUB: Come on...don't ask me...I don't even know if I believe it's endocarditis. (his phone rings with a text message) Oh's my consulting job - they want me to work on some new case.
FOREMAN: So you're just gonna run out on us and go work on some new case? (actually...he's going to go get the other kid an MRI...good for him)

MASTERS: Dr. now a good time to talk?
CUDDY: Not really.
MASTERS: know how you had us consulting on your mother's case and then stopped it?
CUDDY: Why are you still here?
MASTERS: Well, I'm afraid the stopping may have...stopped. House put me on this weird case where there's no treatment...I think to distract me. They're all acting really weird.
CUDDY: I'll look into it...
MASTERS: See, I'm worried that he might be...switching your mother's meds. I checked with the pharmacy and Dr. Chase got Prednozone and IV antibiotics...both for this coma patient. Neither of those would treat his problem...but...
CUDDY: Both of them could treat my mother. I'll get to the bottom of this...thank you for bringing it to my attention.

HOUSE: You told me to keep you out of it! What the hell did you think that meant?
CUDDY: I meant if you had to slip her a few more vitamins...this is life's illegal! I wasn't expecting something like this!
HOUSE: Only because you were intentionally not thinking about it because you don't want to make any tough decisions. (hit the nail on the head there...Cuddy backs down)
CUDDY: Are you completely sure it's endocarditis?
HOUSE: That's not a real question. Endocarditis fits better than the alternatives. (you know this is how House works, Lisa...)

CUDDY: Where's Julia?
MOM: She has a family.
CUDDY: I have a family.
MOM: Three kids and a husband...that's a family. ('re still a bitch...check)
CUDDY: You are always so much tougher on me than Julia...why is that?
MOM: I'm not!
CUDDY: I was thinking about that time you made me run for yearbook editor? I didn't want to...but you said you knew best. You let Julia do whatever she wanted...
MOM: We're debating twelfth grade now?
CUDDY: Like anything has changed?
MOM: What do you want, Lisa? Do you want to hear me say I love you both equally? Of course I do!
MOM: But times like this...when we argue...they remind me. I have more in common with her. She's nicer to me. I love you both...but I like her more. (Seriously, Mom? SERIOUSLY?!?!)

FOREMAN: We're not talking about simple antibiotics now. Amphotericin B is dangerous on its own. It's a poison, that's why it kills fungi! She'll get a fever, chills, respiratory problems...
HOUSE: All of which she already has, which will make it easier for us to hide it!
CUDDY: I don't think I can take a risk like that.
HOUSE: Well then you shouldn't have let her fire me!! (here his real anger is showing...because Cuddy couldn't stand up to her mother and defend House, he feels personally betrayed and he fears she'll still blame him for the consequences) All we have to do is change her IV.
FOREMAN: This blew up on your once before.
CHASE: He's right.
TAUB: Yep.
CUDDY: I'm sorry, guys...I never should have gotten you into this mess. You can go. All except Masters, Cuddy and House exit.
HOUSE: I'm right.
CUDDY: I know. And I'll do's just...
MASTERS: I agree...fungal endocarditis fits best...but...we still have to tell your mother.
HOUSE: I'm kicking you out of your office. (Cuddy looks confused) Yes, you. This isn't her office yet. (Cuddy reluctantly leaves) If you tell anyone...I will have you thrown out of med school. I'll destroy your career.
MASTERS: I've thought about that. But lying about me...won't work. Everybody knows your reputation.
HOUSE: True, but I won't have to lie. Buried in your coma patient's big big file is a form forbidding any doctor from administering treatment without consent of the relatives. You drew blood. That's not just a screw's criminal assault.
MASTERS: Wait...but you told me...
HOUSE: Nope! As you will recall...(he makes the same zipping gesture over his mouth tha he made before).
MASTERS: You set me up. Why?
HOUSE: Because this the highest priority. (and Masters runs off

LAWYER GUY (after smashing Taub's face): You made her think I was hiding her son's condition! She stopped the settlement...and reported me to the bar! I gotta deal with that crap now? I will sue you for slander...for tortuous interference...and anything else I can think of to destroy you. Oh and my sister says to stay out of her life forever. You failure!

MOM: I want you off my case.
KAUFFMAN: That's exactly right.
MOM: Don't get excited, you're fired too.
KAUFFMAN: What? Why?
MOM: I'll never get away from House and my daughter if I stay here. Transfer me to Princeton General.
CUDDY:'re very sick, and you're very angry. Do you really think now is the best time to make this kind of decision?
MOM: You lied to me...and you betrayed me. Do you really think I give a damn what you think is a good idea right now?
CUDDY: Fine. I'll get the ambulance. (wuss)

CUDDY: I can't believe it. What just happened?
HOUSE: You just killed her. (ow)
CUDDY: You're blaming me? None of this would have happened if you hadn't be so arrogant! You goaded her into firing you!
HOUSE: Actually my mistake started right after that...when I agreed to your brilliant plan of keeping me on her case after she fired me off of it.
CUDDY: She would have left the hospital.
HOUSE: Only because you let you just did.
CUDDY: You don't think I stand up to her?
HOUSE: I don't think you've ever tried.
CUDDY: I've been rebelling against that woman my entire life!
HOUSE: Here's what I've seen. She insults you, you complain to me. I drug her dinner, you never tell her. She wants to leave the hospital, you let her. You never stand up to her! And it pisses me off!
CUDDY: Are you taking this personally?
HOUSE: She leaves...she dies. Then one day...maybe next week, maybe next're going to decide that the man sleeping next to you killed your mother. Get me my patient back.

CUDDY: I figured out why you were always so tough on me.
MOM: I wasn't.
CUDDY: You were! And I know why. You saw something in me...something you didn't see in Julia. Something you didn't see in yourself...a type of ambition...a type of brains. So you rode made me the yearbook editor, suma cum laude in undergrad, AOA in med school. The only time I ever see light in your eyes is when I talk about my career. The reason you keep coming to me in the clinic is because you trust me. You trust my medical judgment. So here it is. If you transfer to Princeton General, you'll be treated well and you'll die. If you stay here...with'll be treated badly...but you'll live. I don't care if I have to slash the tires of every ambulance in this bay, Mom. I am not letting you leave my hospital.

HOUSE: I love A-Rod...I have nothing but respect for him as a person and a player. I'm especially fond of those pictures he has of himself as a centaur. I like A-Rod? (LOL!)

TAUB: I thought you didn't want to see me anymore.
RACHEL: I didn't. But I didn't know you thought that little boy had a bleed in his brain. I will kill my brother if he messes with you again.
TAUB: What do you care?
RACHEL: were a crappy husband...but you are...a good person (and they hug...this is a very sweet moment)

HOUSE: Once again, you are unfired.
HOUSE: You sold me out, even though you knew I would get you thrown out of med school. That's just...kind of impressive.
MASTERS: So...I keep my job if I stand up to you...I keep my job if I don't? I don't buy it.
HOUSE: When Cuddy was protecting you before, she wasn't protecting a doctor...she was protecting her boyfriend. That kind of thing isn't tolerated in a Dean of Medicine. So...I need you to protect me...from doing something Cuddy will regret. (aaawwwww)

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