Most of this episode is told in flashback because something so horrible has happened that House has finally been dragged in front of a disciplinary hearing. Sure, that happens like four times a year, but this time it's for serious. Honest. Oh, and it's because Chase got stabbed partway through. I think it's probably Chase's fault, but I wasn't asked to testify.
The main case is a chemistry teacher who collapsed while jogging. This is why you shouldn't accidentally cause explosions that break your tumors apart. And Chase also has a case to be diagnosed, but since everyone saw him get stabbed, it's not as much fun. He's briefly paralyzed and ends up having to learn to walk again. And he gets an apology from House, so maybe it was all worth it?
This room is a mess! There are drugs and blood everywhere. A hypodermic lies unattended on the floor. So does a scalpel. There are neglected balloons AND flowers. And everything's in slow motion and oversaturated so we know this is a very important episode we'll remember forever. "Remember that episode that started with a bunch of junk thrown around in a patient's room?" we'll say. And then we'll laugh and laugh.
Elsewhere, in a world almost devoid of color, House looks up at his reflection in a bathroom mirror. He splashes water on his face and limps off to the office of a guy running a disciplinary hearing. The guy clicks on a teeny recorder and exposits that we'll be talking about the events of February 3, 2012 in patient room 209. House has a question: "Who the hell are you?" The answer is, "I'm Walter Cofield. Chief of Neurology, Mercy hospital. I'll be deciding your fate today." That's a lot of exposition, but I appreciate the effort.
House suddenly knows everything about Cofield, including the fact that he's Foreman's old mentor. He thinks it's interesting that Foreman selected his old mentor to judge his new mentor. He declares that the facts are in the folder and gets up to leave. Cofield says the facts would lead to House being suspended, which is a revocation of his parole. House sits again, because this entire season is about House being forced to do things by the threat of going to jail. House rushes through the patient intro for Cofield. It's a 32-year-old high school chemistry teacher who collapsed while jogging. He had paralysis in all four extremities.
Flashback! Foreman is begging House to help him solve this thing. House is bathed in an angelic glow. In the modern day, Cofield doesn't buy the glow. House pops a Vicodin, which Cofield looks askance at. House cheerfully admits that he took Vicodin during this case. And the other nine years of cases. He claims that his process is proven, and that good things usually happen and bad things rarely happen. Cofield wants to find out why bad things happen, and House accuses him of just trying to assign blame. "It's nobody's fault."
House insults the patient, and we see Cofield interrogating Adams. He doesn't think House was really so casual about his patient. Adams says she doesn't think it was House's fault. Now Taub is talking to Cofield, and apparently this is going to be an episode in which a lot of different people are describing events. This presents a challenge to the recapper, and I am going to solve the problem by ignoring it. From now on, I'm either describing the case (shown in flashback) or the disciplinary interviews (shown in the present) and it's up to you to figure out which. Each interview is one-on-one, if that helps.
Taub says the initial diagnosis was liver problems. Park says House thought that was a stupid idea. Her idea was normal-pressure hydrocephalous, which House also thought was stupid. And he gets Cofield to explain why, since it conflicts with something in the patient's history. In the flashback, House tells Park to "unsquint your eyes," which Cofield interprets as a racial slur. I guess it could be. House makes a prescription: steroids.
Cofield asks about some orange smudges on the papers. House claims they're Cheetos. They're not. In fact, Chase has accidentally dyed his hair orange as a result of House messing with his shampoo. Adams tells Cofield that House mostly just likes to cause chaos. I think Chase did a great job with his hair, considering that he apparently did it accidentally. It's very evenly colored.
up: Bill the patient wakes up and is thirsty. His name is "Bill Cofelman" or something like that. It could even be Cofield, frankly. Taub tells him they think it's an overactive thyroid. Bill wiggles his fingers and two of his students show up. They ask, "Is he sick because of the explosion?"
Taub has to explain to Cofield that the explosion wasn't in the initial patient history because the patient had been unconscious and thus unable to provide much information. And the wife didn't know about it. Taub emphasizes that he was the one who interviewed the patient, so any fault was his own. He then explains that House avoids patients to stay neutral.
Now House gets to explain his thesis: "If you want an accurate patient history, don't ever talk to the patient. Everybody lies. ...except me. To you. Would never do that." I should point out that Cofield smiled at "Everybody lies," suggesting that he agrees. But Cofield says that reading body language is an important part of getting the case. Can House dispute that the case could have ended differently?
Bill says it wasn't an explosion but a rapid chemical reaction. The student says it totally was an explosion. And it's on YouTube! Bill promptly starts coughing up blood. Oh! Get this: "viral video." Right? Because they just mentioned YouTube and he's got a mysterious disease. Aw, c'mon. That's gold.
Cofield is shocked that House found it "interesting" that his patient was doubled over in pain and coughing up blood. He would apparently prefer it if House found it boring?
Bill is showing off his video. There's too much hydrofluoric acid in the air, which caused a fireball. The team figures he inhaled the hydrofluoric acid and bonked his head. Park is skipping steps when she tells Cofield about her theory about paralysis. Then she makes eye contact and gets to the part of the story where House wears a gas mask and brings a stink bomb into the meeting. He insists that they talk about treating chemical burns inside the lungs. No water; it would drown him. Burn cream, too. Taub throws out aerosolized Hefferin, which is certainly not the way that's spelled.
House looks embarrassed as he tells Cofield that aerosolized Hefferin has been tested on sheep. Cofield thinks he used the smoke bomb to pressure his team into coming up with a dangerous idea. Park tells Cofield she called it "insane." He tells her she failed to speak up properly. She answers, "And that's why I went to Dr. Foreman." We see Foreman tell her that House thinks this is the only way to do it.
Then there's a fancy pan from the oversaturated flashback to the dark, undersaturated modern day. Cofield is telling Foreman (who I guess ran over there as soon as he was offscreen) that he didn't mention being involved in the case. Foreman evades with, "I wasn't. The Hefferin decision didn't have anything to do with it." Cofield thinks signing off on everything House does establishes a pattern that lets House get away with things. Foreman claims that House is brilliant. Cofield recaps the parole problem. Cofield realizes that Foreman brought him in to run the hearing because thought he'd have his back. He's disappointed. It's not his job to protect Foreman.
Adams confirms to Cofield that the patient got a dismissal order, but they gave him a sponge bath first. He's got a rash and he's pretty whiny about it. He just wants to get out. Park tells Cofield the rash was just irritation. But according to her, the patient's brain was the problem. He freaked out. Adams says he didn't "freak out." She blames invasive strep. Park says it was psychosis. Taub says the neurosymptoms and the rash were symptoms of Wegner's. Cofield asks House how he handles this sort of competing-diagnosis situation. House explains that he runs a diagnostic trial.
Specifically, corticosteroids. If Taub is right about it being Wegman's, it'll cure him. If Adams is right about it being strep, his fever will spike and then they can cure him. And if he just goes crazy, then Park was right about it being psychosis. Cofield doesn't like this technique, since two of the three results make the patient worse. House insists that the most important thing is to nail down a diagnosis. Cofield asks if he still thinks it was a perfect diagnostic outcome "in light of what happened." House says it was. It accounted for all medical outcomes, but not his team's disobedience.
We see Chase and Adams preparing to do an unauthorized biopsy on the rash. Chase loads up some lidocaine in a hypodermic needle and Bill jumps up. He's acting crazy! Fight! Fight! Fight! Chase drops the hypo, which is clearly the hypo from the opening scene.
Cofield asks House whom he blames: Adams or Chase? He blames neither one.
Taub runs into the room. The one where Bill is going crazy all over Chase, not the one where House is being interrogated. There are orderlies! Taub injects Bill with something. He goes limp. Adams has blood on her. Because Chase has a scalpel sticking out of him! The scalpel falls. So does Chase. He's got a giant gash on his torso. Arterial spray. Adams: "It's his heart."
She tells Cofield that the tip of the knife reached his heart. Her finger blocked the hole. She blames herself for having the wrong theory about what was wrong with Bill. Chase gets wheeled off to surgery while Adams sits on his chest with her finger sticking into his chest to plug the hole in his heart.
House tells Cofield that his diagnosis was correct: steroid-induced psychosis. Cofield asks if House cared about his colleague. We see House enter the surgery, where Adams doesn't want to pull her finger off the wound. House says he's 100 percent oxygenated and it's time to operate. Once they suture Chase's heart, House wants to know what the patient's heart rate was. Adams is shocked that he's DDXing. No one will go with him so House leaves.
Cofield thinks House was callous. Taub says that doesn't matter. He also says that they all knew that a psychotic episode was a possible outcome, and that Chase brought a scalpel in there. He appears to blame Chase.
House examines the patient's room, which is a mess. Blood everywhere, remember? He finds the heart rate paper and considers it. He wanders off to post-op to find his team clustered around Chase. Chase has not woken up yet.
House: "Lungs. Rash. Now excessive RR variability. Go." Taub says there are plenty of doctors who could help him. House says that the three of them are, what, uniquely suited to the job of sitting to Chase? House waxes poetic about Bill's wife, but Adams says she's not pregnant. They tell House to shut up. Chase wakes up and asks if he got an epidural. Because he can't feel his legs! Bum bum BUMMMMM!
Cofield now goes to talk to Chase, who's still laid up in bed in the modern-day scenes. Chase knows who he is. And he points out that he can't get up and run away. His hair is normal because he dyed it back. Out comes the recorder. "Were you angry with Dr. House?" "It was a prank. It wasn't uncommon." Also, why does that matter? Is Cofield trying to prove that Chase was compromised? Why does it matter who was at fault? Chase says, "I don't think it was anyone's fault. I was angry, but I wasn't distracted. And I think that if there's any chance I'm going to walk again, it's because Dr. House is a genius."
Flashback to right after Chase said he couldn't feel his legs. Chase can't feel anything on his skin. Chase suggests post-traumatic...something. It would mean permanent damage. House suggests arteries, not nerves. Let's try an embolectomy!
Surgery. Chase wants to see the monitor showing the camera poking through his arteries. Sure, why not? He's awake and he's a doctor. They do find something. House barges in to announce that Bill is being transferred out, and he wants emergency diagnosis work. Chase explains to Cofield that House was actually checking on Chase's progress, but he needed an excuse to be in there. Cofield is just starting to understand House's craziness, but it's not like it comes as news to viewers of the television program. House is callous and brilliant. We know. Move on. Cofield claims that Chase's toe moved. And it does! He pokes Chase's foot and Chase can feel it. It was the clot! Oh, and how come Chase brought that scalpel in there? "I thought I was right about the rash. I would do it again." "I thought so." Chase wants to know what that means. "You brazenly defied your boss." But was that because House has established that's okay or because Chase was distracted or because medicine is a game? Either way, Cofield feels that House has created an atmosphere that promotes recklessness, and that's why Chase may never walk again. He tucks in Chase's foot and leaves. So...he's saying that because House dyed Chase's hair orange, it's his fault Chase got stabbed? Because House has done much worse things than that.
Last round of questions. House claims he hasn't heard that Chase regained movement. Cofield turns off the recorder and asks if House is really that indifferent to the well-being of his coworkers. House shrugs, "Are you gonna have me fired for bad manners?" He puts his feet up on the table between him and Cofield. Cofield claims he's trying to understand why House insists on acting like an ass. Recorder on. He says, "Put the Vicodin away, Dr. House." House makes no attempt at all to sound convincing when he says, "My leg hurts." POP! The Vicodin bottle blasts confetti everywhere. Cofield is not amused. House gets Epiphany Look. House: "Two explosions." He gets up and leaves. Cofield calls after him, "We're not done here!"
House goes out to the ambulance, where they refuse to open the doors. It drives away with Bill inside. House limps after the wife and uses his cane to stop the elevator doors from closing. I like when he uses his cane as a prop because it reminds me of that great episode of NewsRadio. He tells her there's a tumor in the lymph nodes. The explosion caused the tumors to break open, which explains everything. What about the psychotic break? "Turns out we caused that." He tells her to tell the new doctors about total-body radiation and plasmapheresis. She says, "Move your cane, please."
Foreman tells House that Cofield left after he walked out. He'll have his decision tomorrow.
Montage! Chase is in bed. Foreman is sitting in a dark room watching the rain. Cofield is in his lovely kitchen, thinking. Chase is still in bed. House is watching him. House walks away.
House enters the Interrogation Room, which is actually quite nice. Foreman enters. Taub enters. Park and Adams enter. Cofield enters.
Cofield starts his recorder and his speech, in that order. "This case is a fiasco. Didn't sleep last night. Dr. House is obviously brilliant." House wants to end it there. But Cofield wants to mope about the dangers of condoning misanthropic behavior. Suddenly! Bill's wife bursts into the room to make a statement. They found the tumor and found the plasmapheresis. They expect a full recovery. "He saved my husband's life. Well. I guess that's it. Thanks again." How convenient! Right in the middle of the verdict!
Cofield gets back to it. House's process is dangerous, inappropriate and effective. So he's decided not to monkey with the process. "Congratulations, Dr. House. This unfortunate stabbing incident is officially nobody's fault." Lots of reaction shots, but nobody really has an expression. House: "Coward." He grabs Cofield's notes, which suggest to him that there was going to be a half-hour speech involved. He knows Cofield was going to send him to prison. He's mad that Cofield changed his opinion because the non-widow came in at the wrong moment. House limps off, angrily.
Chase is walking an inch at a time on the parallel bars they use for people trying to walk again. House wants to know how Chase rigged his Vicodin bottle. Then he explains all the stuff he learned about Chase from his use of Adams's shampoo. House tells him that his being stabbed was officially nobody's fault. "They're wrong. I'm sorry." "Anything else? Kind of busy." House glares at him, annoyed that his apology wasn't received with more ceremony. "Nope. That was it." Chase strains.
Follow Monty on Twitter at @montykins and read his blog, Mysterious Exhortations.