So, here it is. The House episode I've been hearing about since I started recapping this show, lo those many months ago; the Emmy-nominated script featuring Carmen Electra as herself; the episode that's supposed to be the best of the season, possibly one of the best in television history, and, of course, one of the hardest to recap. Should be fun.
Today's pre-credits medical disaster takes place before the show even starts, as one of the guys who puts the "teaching" in "Princeton-Plainsboro Teaching Hospital" is out sick for the fifth time this year, leaving Cuddy to make a deal with House to substitute. Even the promise of two hours of Clinic duty doesn't appease House, who asks why he always gets stuck with this stuff. "Because the world hates you," Cuddy answers. "Or, because it's a class on diagnostics." I don't see why it can't be both. House refuses to do it, and walks out of the office. He gets about five feet away before he turns back around. Cuddy -- who's probably about to offer House more Clinic hours off herself -- hurriedly pretends to be nonchalantly consumed with paperwork when House re-enters, telling Cuddy that she was supposed to stop him and re-negotiate. "And you were supposed to keep on walking. Sorry, I guess we both screwed up," Cuddy says. As we'll see in less than an hour, that quote doubles as both yet another example of how awesome Cuddy is, and as an overall theme of the episode. House says that he'll do the lecture for four hours off Clinic duty. Cuddy sticks with two, saying she knows that House would rather spend the time listening to himself speak than his patients. Foiled again, House goes off to teach.
As House walks through the Clinic on the way to class, the fabulous Evil Nurse Brenda stops him to see a patient. House tells her to go talk to Cuddy, because he's off the seeing-patients hook for now, but then a woman calls out his name. His first name. He turns to see Sela Ward, the mysterious Stacy. She's awash in angelic lighting and sad piano music as she steps toward House, whose face reads just about every emotion except happiness. She asks him how he's doing, and he says that "the last five years" have been like those Girls Gone Wild videos. Stacy asks if House means that he's been living them, or just watching them, and I guess we're supposed to see that she is as quick with the witty comments as her ex-boyfriend is, but that line just makes her look pretty mean, especially considering what we find out later about whose fault it is that House leads such a lonely and unhappy life. Stacy tells House that she missed him, but not so much that she didn't go off and get married to a guy who now needs House's professional help. House didn't know there even was a husband, and this really could not have been the best way for him to find out. I mean, honestly, Stacy. I really want to like you, since I'll be saddled with your face episode and for at least seven episodes season, not to mention that I really don't want my two least favorite characters on this show to be women because then I'll start to wonder if I'm just being one of those petty women-hating women I've had such bad experiences with, but you are not making it easy so far.
House checks out Mr. Stacy's charts, quickly notes that vasculitis has been ruled out as a source of his abdominal pain and fainting spells, and instadiagnoses it as indigestion or possibly a kidney stone. "Did you think I wasn't going to get married?" Stacy asks, because why say things that would make the person whose help you need want to help you when you can totally turn him off? House tries to walk away, but Stacy follows him and says that her husband has been to a ton of doctors, and no one can figure out what's wrong with him. But she knows that something is, since after living with House for a while, she managed to pick up some medical knowledge through osmosis. He, apparently, received some of her constitutional lawyer know-how in return, judging by his winning motion back in "DNR." Stacy says she has also observed mood swings and mental confusion in her husband, which House says could indicate that the mystery illness has a neurological component to it, or that Mr. Stacy is having an affair. Either way, House won't take the case. Stacy says she doubts that House has anything else to do, judging by his past behavior of avoiding heavy workloads at all costs, and House admits that it's not that he's too busy: "I'm not sure I want him to live." Oh, SNAP! House gets to live out #2 on every scorned lover's fantasy revenge list (the first being, of course, sewing dead fish into your ex's curtains and/or car upholstery)! Stacy's eyes well with tears, as they will be doing for the rest of the episode except for the parts where they're supposed to be welling, but remain oddly dry. Anyway, House tells Stacy that it's good to see her again, and leaves for his lecture.
"Three guys walk into a clinic," House begins his lecture to a smattering of uninterested students in a large lecture hall. "Their legs hurt. What's wrong with them?" Immediately, a guy who you know is the dorky overachiever -- because he's wearing glasses and also was the first person to raise his hand -- raises his hand. His answer is muscle strain, and the proper course of action is to apply heat and rest all affected areas. Yes, well, seeing as this is a lecture for medical students as opposed to a basic first aid training seminar, I'm thinking it'll be a tad more complicated than that. House says that, statistically, the nerd is correct most often. But there are other causes too, like pregnancy-caused varicose veins (seriously, what horribleness does being pregnant NOT make you susceptible to on this show?) or car accidents. Another student, an eager young lady who has just got to be the med student version of Cameron, asks what the three patients were doing when the muscle pain started. House says he doesn't know. A third student, played by Andrew Keegan, also known as 7th Heaven's Wilson, doesn't believe House that a medical history wasn't taken, making him kind of a medical student version of Foreman. Which means that eager-to-please suck-up is the student version of Chase. This also means that he should be more attractive, but why quibble? House says that a history only tells you what the patient said happened, which may or may not be consistent with reality.
Patient A is a farmer. We cut to a bucolic little farm scene. Patient A, dressed in the stereotypical hick farmer attire the local paper of my Connecticut hometown always put editorial cartoon representatives of its residents in, down to and including a long strand of hay in his mouth, is fixing a fence. House narrates that the farmer experienced tightness in his ankle and then a loss of muscle control. The farmer groans and falls on his ass. Ankle pain be not proud.
Patient B was at volleyball practice (and he is played by the same guy who played the farmer, although he has traded his overalls for a tight women's volleyball uniform) when he dove to for a ball and hurt his leg.
Patient C is Carmen Electra, playing mini-golf dressed like the late Payne Stewart. And yes, she is played by Carmen Electra. Which is really awesome.
StudentChase interrupts to excitedly ask if House actually treated "the Baywatch chick." House says that her proper title is "the Baywatch thespian," and no, he did not. He was disguising all three patients' true identities, and he got sick of the standard middle-aged guy, so he went for a more "pleasant" alternative. Pleasant for House, maybe, but probably not for the Fox executives who were in charge of coming up with the money to get Carmen Electra. House adds that in less than two hours, one of the three will have been thrown out of the hospital for faking his condition to score narcotics, while another will be "close to death." If I know my hospital waiting rooms, the third will still be waiting to be seen by a doctor and on the last remaining copy of People magazine the waiting room has to offer.
Let's start with the farmer. We go to an exam room in the Clinic, were our farmer is lying on a table as House asks him questions about his leg. The farmer says he was fixing is about a half-mile from his farmhouse, and that the pain started in his ankle and is radiating up his leg. StudentChase appears in the scene to recommend taking a family history. House asks the farmer whether his family has a record of leg ailments, and the farmer says they do not. StudentCameron appears to recommend drawing blood for tests. Finally, StudentForeman appears to suggests doing an MRI, and he and StudentCameron proceed to argue over whether they should do and MRI or a PET scan, until House informs them that their patient just died. StudentChase whines that they didn't have time to do any tests, and House says that they had time to at least look at his leg. Our middle-aged male farmer is now played by Carmen Electra, as House points out that if you're going to look at a fake patient's legs, they might as well be really nice ones.
Carmen Electra removes her pants as House stands in the corner and leers. She twists a strand of hair in her hand as House does a close and thorough inspection of her right leg, whereupon he finds a puncture wound. StudentCameron guesses it's a snakebite, but StudentForeman is a little skeptical that you could be bitten by a snake and not know it. House says that the farmer was standing in tall grass, making it possible for him never to have seen the snake. StudentChase asks what kind of snake it was, and House says that they don't know that yet. Fortunately, "there are people to find those kinds of things out."
The real Chase and Foreman walk up to the farmer's fence, where they are told in no uncertain terms by his vicious guard dog that their presence is not welcome. House says that it's time to go check on their volleyball player.
Real Cameron is tending to the volleyball player and the ridiculous camel-toe his tight short-shorts have created. She diagnoses him with tendonitis, and he strikes a feminine pose with his hand to his forehead and tries not to cry. StudentCameron interrupts the scene to ask how old their volleyball player really is, since she's thinking that a middle-aged man is not playing on a high-school girls' team. House asks her if she'd care more about her patient if she were a young female, and StudentChase says that, of course, they should care about all their patients equally. House tells him to stop caring so much about Carmen Electra, because she is House's fantasy patient and no one else's. He then tells StudentCameron to stop being so much like the real Cameron and care a little less about her patients, as the real Cameron asks our volleyball player, who is now a sixteen-year-old girl, to tell her everything that ever happened to her or anyone in her family, ever. Cameron then reports back to House that she didn't find anything suspicious in the family history, but that she did find out that a boy's volleyball team member made out with our patient at a party and hasn't called since. Somehow, Cameron takes from this that the patient is depressed, and not because of her tendonitis or relationship problems, but because of the nodule Cameron found that indicates that she has a thyroid condition. House agrees that thyroid gland problems can cause both depression and tendonitis, and Cameron is off to run the appropriate tests.
StudentCameron interrupts to point out that her real counterpoint's over-interest in the patient led her to find the real cause of her problems, which would indicate that getting personally involved is a good thing for the patient. House says that actually, the thyroid thing turned out to be nothing, and the patient was subjected to an "expensive and painful tests," as if this were something that House usually tries to avoid.
"Here's how a well-adjusted doctor handles a case," House says, and we cut to him and Carmen Electra, back in her golfer clothes. While it's possible that you're the most well-adjusted person in the exam room, House, I wouldn't take it much further than that. He taps on Carmen's knee with a rubber hammer over and over again until she asks if she can put her pants back on. House says he'd rather she didn't, and StudentChase interrupts the scene to ask why not. House just gives him a "duh" look and returns to the exam room, where he tells Carmen that her knee reflexes are slow. StudentForeman diagnoses a slipped disc, and House asks Carmen how bad the pain is. "It hurts really, really bad," she says. StudentCameron scoffs that this seems fake, having already assumed the jealousy of her real counterpart whenever her crush finds another woman attractive, be she fictional or real. House tells StudentCameron that he's sorry if Carmen Electra isn't Meryl Streep, but she was not chosen to be in his fantasy because of her acting abilities so it's not fair of StudentCameron to judge Carmen Electra for that. If StudentCameron really can't do this without a more realistic representation, however, House is happy to oblige.
Carmen Electra is now a middle-aged man (not the same actor who played the farmer and the volleyball player) whose screaming makes it difficult for anyone to ask him questions about the location and intensity of his pain. StudentForeman wants to shoot him up with painkillers so that they can talk to him, but StudentCameron says they don't know if he's allergic to them or not. House holds up a syringe full of narcoticy goodness as the students quibble. The patient loses patience and grabs it from him to injects himself with it. He immediately feels better. A lot better. Maybe a little too much better. Back in the lecture hall, the students say they screwed up and gave an addict more fuel, but House says they did exactly what the real-life doctor did. Addicts are very good at tricking doctors into giving them drugs, and it happens all the time. Oh well.
Back on the farm, the Humane Society has been called in to deal with the farmer's dog and catch a guilty-looking snake. They get a Timber Rattlesnake, and Chase calls it in. Cameron administers the correct antivenom to the farmer, promising that he'll be feeling better very soon. Of course, he goes into respiratory and cardiac arrest, thanks to a severe allergic reaction. Cameron calls for the defibrillator paddles. Back in the lecture hall, House calls for a five-minute coffee and pee break.
House spends his break time with Wilson, talking about the reappearance of Stacy. Wilson asks House if he's going to help Mr. Stacy, and House non-answers that there's probably nothing wrong with the guy. Wilson says he really doubts that, since the only reason Stacy would be "anywhere near" House is if "she was desperate," which can't do House's ego any favors. House asks Wilson if he's saying that House should take Mr. Stacy's case because Stacy hates House, and Wilson says that Stacy's feelings for House are very much the opposite. She's been avoiding him all this time because it's kind of tough being around someone you love when you're married to someone else.
StudentChase pokes his head into the hallway to tell House that this five-minute break is rapidly approaching the six-minute mark. In a few years, that same kid will have patients scheduled for 11 AM appointments who don't see anyone until past noon, so I hope he enjoys his desire to keep things on time while it lasts. The students take their seats as House re-enters and starts talking about their volleyball player. StudentForeman, who has now moved up a few rows from his seat toward the back, tells House that he "doesn't care" about the volleyball girl when there's a more interesting dying snakebite victim to deal with. House says he's sorry the volleyball player isn't as exciting as the farmer, but her T4 test came back low, meaning she does, indeed, have a thyroid condition along with her tendonitis, and that the "expensive and painful" test Cameron put her through was not unnecessary after all. That kind of makes his whole "don't get too involved" lesson about as weak as an abstinence class that only talks about how much fun sex can be.
Cameron gives the girl some drugs for her thyroid. The girl thanks her, swallows the pills, and lies back in bed. Back in the lecture hall, StudentForeman is disappointed at the boring outcome. He might as well get used to it, since Cameron isn't leaving the show like those last few episodes teased us that she would. House says the farmer was, indeed, more interesting. And gross, too!
We cut to the farmer's puncture wound, which has grown considerably in size from the last time we saw it, and has started turning black around the edges. In House's office, Foreman says that while they managed to stabilize the farmer after his allergic reaction, the antivenom isn't working. It looks like the Humane Society caught the wrong snake, as evidenced by the fact that they managed to extract more venom from it than it should have if it had bitten a guy just four hours ago. You'll notice that House knows a lot about snake venom glands, which is probably because he's trying to create some for his own mouth in his home research lab. Back in the lecture hall, StudentCameron says they should go back and find the correct snake. House says that they could do that, but that it would be a lot easier, not to mention quicker, if they did a quick internet check to find out that only three poisonous snakes are common to the New Jersey area, two of which have the same antivenom they already gave to the farmer. That means chances are really good that the culprit is the third snake on the list, a coral snake, so they can just give the farmer the antivenom for that. StudentChase points out that the farmer may have been bitten by a poisonous snake that isn't common to New Jersey, meaning that they should wait until they know something for sure before they treat the farmer. "Very good," says House. Except not really, since by the time they know anything for sure, their patient will be dead. House takes a class vote on who would administer the coral snake antivenom, and who would go off looking for the correct snake. The half of the class that watches too much Crocodile Hunter and therefore thinks that snakes are easy to find and catch raise their hands for the second choice. "Half of us killed him and half of us saved his life," StudentCameron says, trying to sound all deep. Shut up, StudentCameron. And do a few logic problems while you're at it, since all you're risking with the coral snake antivenom route is that it's the wrong antivenom and the patient's condition will continue to decline, which is exactly what would happen if you waited to for confirmation anyway. The waiting-for-confirmation route, on the other hand, risks your patient's life if the results don't come back in time. StudentChase says it's not fair that they be held responsible for making a choice that wasn't necessarily right or wrong in the first place, to which House says that, in this field, the ultimate judge of the correctness of their decisions is the outcome, pure and simple. If you do everything you're supposed to and your patient dies, then you're wrong.
We're back in the farmer's hospital room, and House says they ended up giving him the antivenom. The Cottages have gathered around the bed, prepared for another allergic reaction. The farmer says he'd like to wait for his wife to get there before they give him the antivenom, and Foreman says they can't. You see, time is short once your leg starts to turn black. The farmer gets the drugs, and this time, he's allergic-reaction-free. House leaves the hospital room, only to run smack into the golfer -- still played by the middle-aged guy and not by Carmen Electra -- who says his leg hurts again.
"On average, drug addicts are stupid," House explains to the class as he dry-swallows some pills. StudentForeman says he'd call the cops at this point, but House doesn't agree. Even drug addicts can get sick, after all, and if your patient dies because you withheld treatment, you can kiss your medical license goodbye. House says there's another, faster way to weed out the actually sick druggies from the fakers: he likes to insert catheters into them without anesthesia, figuring that only someone who was in some serious real pain would be able to stand having a thick rubber tube shoved up his penis. House does not say whether this method applies to women as well.
House roots through the sick professor's desk, where he finds some pictures of the guy with his kids and a "World's Greatest Dad" coffee mug. The always-doubting StudentForeman says that if the guy were desperate enough for a fix, he'd deal with anything. House says it's much more likely that he'd just go to a different hospital where the staff didn't have a pre-existing relationship with him. House takes the mug and leaves the lecture hall, calling back that their volleyball player is not responding to the thyroid treatment. Way to go, Cammy. House fills the mug with water from a fountain and asks the class if they can still hear him. The three actors who were paid to speak say "no," "a little," and "not really," while the background extras are forced to remain mute.
The volleyball player complains that her arm really hurts, as Cameron tries to stick her with an IV needle. Cameron is very sympathetic and very ineffective. She reports back to others that their patient is now "very sensitive to touch," as opposed to Cameron, who is "very sensitive to anything that reminds her of her own numerous issues." The Cottages rattle off various possible diagnoses for the volleyball player until StudentCameron asks House to "slow down." He responds by spitting the gulp of water he just took back into the mug and making a sour face. We'll find out later that that was not a spit take at the incredible stupidity of medical students. You don't tell House to "slow down" because then he'll repeat himself with exaggerated slowness as if you were retarded.
House does this back in the meeting room, House finishes slowly telling the Cottages to do some bloodwork and a neck scan on the volleyball player, and then announces that it's time to move onto the farmer. The Cottages are confused. House reminds himself that the farmer's case didn't come in until three months AFTER the volleyball player did. In Storyland, however, "time is not a fixed construct." Let's hope that theory extends to my recapping wages, since this episode should really count for like, one and a half recaps. ["Nice try." -- Wing Chun] The farmer is not responding to the second antivenom. They've run out of options.
"We're too late?" asks StudentCameron, trying to not to cry at the sadness of it all. You see, Farmer's untimely death makes her think of her dead StudentHusband. House hobbles down off the lecture hall stage and asks the students who wants to let the farmer's wife know that her husband is a goner. For the first time this episode, StudentChase's hand does not fly into the air. House says that, actually, the farmer isn't married, which makes the bad news-breaking a little bit easier. Another thing they should know: their drug addict is peeing blood.
Back from the commercial, House uses a yellow crayon to color in a piece of paper as he asks the class if they've learned how to tell a patient that he's dying. I hope, for the patients and their families' sakes, that they didn't learn it from whoever taught Cameron. StudentChase says that they've done role-playing in their "how to be the messenger who doesn't get shot" class, which must have been a lot of fun for the more performance-inclined members of the class. I know I would have a blast in the role of the Dying Patient as I railed against the God who let this happen to me and then tearfully accused the doctor of my murder. Depending on what I was fake-dying of, I would request that my kidney be donated to an ailing neighborhood child, because if I'm going to play a character, it's going to be someone who's really noble and stuff. Back on the show, House says he has a "buddy" who is so good at delivering bad news that his patients have been known to thank him when he's done. Shit, I don't even thank the guy who delivers my Amazon orders. House is either talking about Wilson or Cameron, who only gets thanked because she would rather lie and tell the patients' families that their loved one made a full recovery and then jetted off to Hawaii, where he will live out the rest of his days in solitude, which is why no one can know where he is or ever see him again, then just say he done died and make them sad. House picks up a brown crayon for his little drawing as he says his patients rarely thank him.
House tells the farmer the bad news: "You're dying...in a few hours." Now, far be it from me, who havee never done any of this role-playing, to say what the best way to deliver news like that would be, but I really think you should just get it all out there and not pause in the middle like that and give the deliveree time to plan out the awesome "why the fuck not?" sky-diving trip he'll be taking in the months before you continue with the "in a few hours" bit. The farmer says he needs to go home. House says he won't make it in this rush traffic. The farmer just wants to make sure his dog is taken care of.
Meanwhile, Cameron and Wilson check the volleyball player for adenomas until StudentForeman interrupts to point out how ridiculous it is that the farmer's first reaction was concern for his dog's future. I don't know if that's necessarily true; I worked with someone who had terminal brain cancer, and her dog's future after she was gone was definitely one of her primary concerns. I don't know if it was the first thing she thought of when she first got the bad news, though, and that's what's important here. House says that everybody lies. In the face of death, you find out what is important enough for them to lie about, even if it means their death.
We return to the farmer, who tells House that neither his neighbors nor the Humane Society are options to take care of his dog. House then realizes that the farmer wasn't bitten by a snake after all, but by his dog, which was already reported once for biting those neighbors, meaning that if the farmer told his doctors that he bit again, the dog would automatically be put down. So the farmer decided to leave out that part of the story, meaning he would die so that his pattern-of-unpredictable-vicious-behavior-having dog may live and probably maul some innocent children. How noble.
Chase and Foreman have been assigned to dog-mouth-swabbing-duty. For some reason I cannot fathom other than that this part of House's story isn't totally true, they didn't come prepared with anything but two rickety wood chairs to pin the proven vicious dog down while one of them swabs out his mouth, which is full of necrosis-causing bacteria. Why couldn't Cameron have been assigned this case?
House finishes his crayon masterpiece and holds it up for all the students to see. And there are, visibly, quite a few more students than there were originally. House's drawing is a red, yellow, and brown blob that matches the color of the druggie's pee. StudentCameron offers a differential diagnosis of kidney stones, and House shoves the drawing in her face to point out that he put brown in there for a reason: the urine has waste in it, meaning that his kidneys are shutting down, but more importantly, that the poor girl who works in the laboratory where the urine sample is sent to for testing is going to get a good whiff of it and immediately reassess her life and its direction, quit her job, and recap television shows. StudentCameron says that the kidney damage could be trauma-induced, from when the patient injected himself with Demerol. House asks what else, and she says an infection. House asks for more, and she thinks hard. "Come on, COME ON!" he suddenly snaps, making her jump. She has to admit that she doesn't know what else it could be. "You're useless," House says. I'm starting to think that House has a personal stake in this particular case. StudentForeman says that they can rule out the infection diagnosis because of a lab result, leaving them with the trauma diagnosis. The patient should apply heat to the area, and he'll be fine in a few days. House tells StudentForeman that he's useless and oblivious, making him worse than StudentCameron. He asks the class what they're missing, and StudentChase protests that it's a little hard to think when they're being yelled at. Idiot. House angrily points out that it won't be any easier when the guy yelling at them is their dying patient.
"WHAT ARE YOU MISSING?" House shouts again. The answer comes from the back of the room: "Muscle death." The answerer is Cameron, who apparently decided to spend her lunch break ruining her boss's lecture. I mean, GOD, Cameron, he was trying to make a point there, both for himself and his students, and you freaking came in and crapped all over it! House looks annoyed, probably because Cameron gave his students the answer and because if she's in there, it means the rest of the opening credits cast will be sure to follow. He tells Cameron that this isn't her case. Smirking, Cameron says that there's "nothing wrong with a consult." Yeah, except that the definition of a consult is advice or information one solicits from another party. And no one asked for your opinion. Go away. StudentCameron latches onto her counterpart's diagnosis, of course, and House says they'll give the druggie an MRI to find out what's wrong with his leg. But it's the volleyball player, not the druggie, who slides into the MRI of DOOM, which doesn't escape the notice of StudentForeman, who's still not observant enough to get rid of that unflattering greasy long hair. House keeps going that the adenoma scan revealed nothing, so her obsessive weirdo doctor (cut to Cameron, looking uncomfortable) ordered an MRI. As for the druggie, neither the students nor his doctors came up with Cameron's muscle death diagnosis, believing it to be the trauma thing and giving the patient bedrest and antibiotics for the three days while his condition worsened. House tells the students that they are bound to make a mistake that kills a patient. If they can't handle that (ahemCAMERONahem), they should do something else with their medical degrees, like teach. StudentCameron can't believe that three whole days went by before the doctors figured out the muscle death thing. House that it wasn't the doctors who diagnosed it at all, but the patient himself.
Back in flashback land, Cameron informs the volleyball player and her parents that the MRI revealed a cancerous tumor in her leg. It will have to be surgically removed, and she'll need chemo, but her chances of survival are excellent. Her leg may have to be removed, though, depending on how big or embedded that tumor is.
Foreman tells the farmer that they found flesh-eating strep bacteria in his dog's mouth. They'll have to remove the damaged tissue from the farmer's leg, and maybe the entire leg as well.
Cuddy herself tells the druggie that the MRI did, in fact, reveal the source of his leg pain. She's really sorry that his doctors were all incompetent ninnies who didn't catch it when it started, and promises to oversee his treatment personally from here on out. The druggie asks if he'll need surgery. Cuddy says they may need to remove his leg.
Back in the lecture hall, House taps his cane on the floor and says, as all the Cottages watch from the back row, that the MRI showed that the druggie had an aneurysm that clotted, causing an infarction the restricted the blood flow to his leg, killing the muscle. "You were right," Foreman mutters to Cameron. "It was House." And first of all, you know that Cameron totally rushed into the Cottages' office just bursting with the news that their boss is giving a lecture right now all about his personal life that he obviously would have rather kept from them, so they should all go down there and soak up all the juicy details. And second, there's some question here over whether House was a drug addict before the leg problem, or if he simply described his story-self as such because that was the assumption that clouded his original doctors' ability to diagnose him properly. There's also the question of how long House has actually worked for the hospital, since this is supposed to take place five years ago and, in the first episode, Cuddy said that House had been avoiding Clinic duty for six years. Yet here, she doesn't appear to have a pre-established relationship with House, and looks like it was her guilt over what her hospital did to him that made her offer his current job to him and also lets him slide on all those questionable ethical things and the inappropriate stuff he says to her. But most importantly, where does this put the Cuddy-House relationship that I'm sure happened on the timeline, since I would have placed it as coming before Stacy, but obviously after they started working together. So many questions, and I don't have any answers. The individual viewer has to make his own decision here, which I think makes for some of the best stories out there, be they literature, film, or a show on Fox.
When we cut back to the druggie, he is no longer the random middle-aged guy, but House. Cuddy says he'll have to have the dead muscle tissue surgically removed, and the whole leg might also have to go. With Stacy at his side, House says he likes his leg. No one is cutting it off.
LectureHouse insists that the patient's choice was correct; surgeons are only too happy to save some work and time and chop limbs off if given the option. StudentForeman Foremans that that is a load of bull. House explains that when you maximize the amount of tissue you save, you also maximize the chances that something will go wrong. We can apply this to actual tissue and the money-conscious cold victim, whose zeal to conserve Kleenex ups the risk that his runny nose drippings will get on his clothes.
FlashbackCuddy tells FlashbackHouse that the days of unwieldy and aesthetically unpleasant peg legs are long over, and that amazing advances in the field of prosthetic legs have been made. House doesn't care. He wants the blockage removed from his leg, even though it will cause all the dead tissue waste the built up behind to clot to be released into his blood system and possibly kill him. The advantage to this is that, providing he survives, his chances of recovering the full use of his leg are good. Cuddy says that the post-operative pain will be incredible. House says he's aware of that, and that this is his choice. Cuddy leaves to schedule the surgery. Stacy tells House he's an idiot for risking his life to save his leg. "I'm not gonna die," House says. That doesn't make Stacy feel much better.
All three patients have their night-before-surgery montage. The volleyball player's parents hold her hands. The farmer uses a Sharpie to write "Not this leg" on his good leg. It's so very sad that this has to be done, especially when the bad leg is so obviously the one that has to go, with the seeping wound and the dead skin around it. Stacy writes on both of House's legs, which are almost entirely exposed as a little treat for the ladies. "Not this one," reads House's left leg. "Not this one either!" reads the right.
Our three patients have their surgeries. Farmer and the volleyball player's are loud with the sound of buzz saws. House's, by comparison, is quiet as the grabby-arm pulls the clot free, releasing all kinds of horrible stuff.
Cut to House screaming in pain and demanding more morphine. Stacy is by his side, and tells him that the doctors say that more morphine isn't safe. In between screams, House pants that those doctors also thought bedrest and antibiotics would heal his dead-ass leg. Stacy tells House that he isn't thinking clearly right now, and he screams that that's why he's asking for the morphine. Because nothing makes you think clearly like opiates!
Stacy asks Cuddy how much longer her boyfriend will be like this, and Cuddy says it depends on how much muscle cell death there was. He may well be in pain for the rest of his life. Stacy looks helpless, and Cuddy says that there is a "third option" -- a "middle ground" between the bypass and taking the leg clean off. "He's not big on middle grounds," Stacy says. Unfortunately, Stacy isn't big on keeping stuff like that in mind when faced with an impossibly difficult choice.
Looking pretty damn sick, House compares the latest printouts from his heart monitor. He calls for a nurse, and tells her that if he doesn't get more calcium glutawhatever right now, he'll go into cardiac arrest. She says she'll get a doctor, and he tells her that she can either waste the less than twenty seconds he has left looking for someone, or just give him what he needs right now. "I could get in trouble," the nurse says, and she either needs to get some better priorities, or better excuses, because getting in trouble isn't worth your patient dying. It's been less than twenty seconds, but the monitors start beeping wildly. "I was wrong," House says right before they flatline. Cuddy and a team rush in. The nurse tells them they're looking at a wide-complex tachycardia, as diagnosed by the patient right before he died. Cuddy zaps him with the defibrillator paddles.
Back in the lecture hall, House says that the patient was dead for over a minute.
As a surprisingly angelic-looking House, dressed in his hospital gown (no open back -- sorry, ladies!) watches from afar, the farmer and his brand-new puppy spend some time by the fence. The farmer takes a second to readjust a screw in his prosthetic leg, and then rejoins the fun. House beams over to the stands at a volleyball court, where the volleyball girl and her totally healed leg are winning games in front of a cheering crowd. She made a pretty quick recovery from the chemo, there, considering her case must have taken place in the less than six months that all three Cottages were working for House. Cuddy gets House's heart going again, and he comes back to his hospital bed.
In the lecture hall, a voice asks House whether the patient's near-death visions were real. If so, he must have been really confused, seeing as he didn't even meet the farmer or the volleyball player until five years later. I'd be kind of pissed if I got a glimpse of my afterlife and it was just two random people engaged in activities I don't find at all entertaining. I hope I at least get some rusty chains to rattle around at night or something. The voice belongs to Wilson, who apparently actually had to do his job when House was in the hospital, since we don't see him by House's side in the flashbacks. House says it is his personal belief that the white light or visions people commonly experience when they die are simply a consequence of the brain firing off random neurons as it shuts down for good, like when you turn off your computer and some random-ass screensaver pops up for a second before it turns off. Or does that only happen to me? I hope it's not another stupid virus. And again, if my brain doesn't have any better neurons to fire off than the ones showing a farmer and a volleyball player going about their daily activities, I'm going to be really angry. Provided that the anger section of my brain hasn't shut down yet, which I'm thinking it won't until the very end. After some prodding from the real Foreman, House says that is what he chooses to believe because it gives him the most comfort. Cameron asks how not believing in an afterlife can be comforting. "I find it more comforting to believe that this isn't simply a test," House says. I'm guessing that's because he was always one of those people who didn't test well.
Back in Flashback Land, House is more and more pain, making Stacy more and more worried. She thinks the pain would have subsided if House were going to get better by now, but House says it's just taking longer than he thought. Stacy urges him to have the leg amputated. "It's my leg. It's my life," House says. When Stacy asks, he says he would cut his own leg off to save her, and she asks why he can't do the same for himself. She cries that House is just as worthy as she is, and that he deserves to be happy. One-legged and happy. House whimpers that he can't tell someone to cut his leg off. Stacy says that the pain alone will kill him. "I need you to talk to the doctor," House says.
House mutters to Cuddy that he isn't doing this again. It should be easy, since he has figured out what was wrong with the sick professor, so he won't need any more sick days. The guy has lead poisoning from the paint in his "World's Greatest Dad" coffee mug that his kids apparently painted for him with the lead paint their stupid dad bought for them. If he switches to plastic cups, he'll make a full recovery.
The StudentCottages think about what they've learned as they pack up to leave class. StudentForeman doesn't appear to have learned all that much, but that might just be because Andrew Keegan looks perpetually stupid. Cuddy already learned whatever lessons she needed to at the time of the actual event, so she just looks sad as she remembers that she was the one who suggested the "middle ground" that turned one of her doctors into a people-hating, drug-addicted misanthrope.
House might have learned something to, as he seems to have forgiven Stacy enough to agree to see her husband. He limps into his office, and the episode ends with a shot of his office door, which reads: "Gregory House, M.D. Department of Diagnostic Medicine." I think the season should have ended right there; there's no way week's season finale will be able to top it.