(Warning: spoilers for the episode that aired Feb. 20)
In an average House episode, it's the CGI shots of a patient's oozing intestines that most disturb me. I found this week's "Skin Deep" the most uncomfortable, disturbing episode so far, for very different reasons. And I don't mean that as a criticism.
House is always entertaining, usually thought-provoking, and occasionally delves deeper into murky ethical waters. The beauty is that when it does, it doesn't wrap the issues up in a nice easily digestible package that allows viewers to partition characters and actions into black and white. We don't have the comfort of knowing House will save the day and all will be right with the world. For while House almost always saves the patient, the world remains a pretty messed-up place. That can be uncomfortable and disturbing, but it's also daring and challenging. And that's a good thing. This is an episode that invites us to look below the surface, past our expectations, past easy answers of good versus bad, wrong versus right.
While a crankier-than-usual House is contending with increased leg pain that Wilson thinks is psychosomatic, a result of sending Stacy away, he focuses on this week's patient, 15-year-old supermodel Alex. Her devoted daddy/manager gave her a little Valium with her champagne backstage, right before she ended up in a "catfight and cataplexy on the catwalk," as House puts it. If that wasn't enough to strip him of the world's best dad title, Alex's father is soon suspected of sexually abusing her. House thinks Alex's hidden heroin addiction is only part of what's causing her symptoms, and that she might be suffering from Post Traumatic Stress Disorder. House doesn't like it when people other than himself cause PTSD in his patients, so he promises Dad confidentiality in exchange for the admission that he had sex with his daughter, once.
Before he gets that confession, Foreman admonishes House to accept that his increased leg pain is causing him to rush the diagnosis. House looks abashed, like he's been shown the error of his ways, gives Foreman a sincere-sounding "thank you," then turns around and yells at Dad in a crowded waiting room: "Are you doing your daughter?"
It's an uneasy plotline, and it wouldn't be House if I could say it was treated with compassion and tact. But it is treated with fidelity to the character of House, who cracks jokes that are wrong, wrong, wrong, and I am going to burn in hell for laughing at them. (House: "Two clinic hours says that those love apples are handcrafted by God." Foreman: "I thought you didn't believe in God." House: "I do now.")
And the story is treated with the intelligence to question a society that sexualizes a teenager, treats her as an adult, then castigates those who look at her as a sexual being, without sympathizing with either side. As the show does in its best moments, it takes our expectations and twists them. When Alex admits to Cameron that she slept her way through photographers and tutors to get where she is before "seducing" her dad so he'd feel guilty enough to let her do anything she wanted, the show is compassionate enough never to let his status as the adult who should know better slip away, and clever enough not to partition her on the side of tarnished purity. She's a victim, but she's also a manipulative victimizer.
It's a creepy line to walk, and House initially gives the appearance of being far creepier than he actually is. When he spontaneously visits the patient - a miracle under less attractive circumstances - he lets Cameron believe that he failed to talk to her about anything medically relevant. He makes comments about Alex's beauty to her pretty face and to anyone else who will listen, but the creepiest speech he gives, the one that made me finally think he'd gone even further than his normal "too far", ends up being a quote from a magazine interview Dad gave about his own daughter, commenting on her perfect, perky breasts and heart-shaped ass. Creepy.
Cameron takes Foreman's place as the one to stand up for what she believes in and tell Cuddy about House's breach of ethics for not reporting the sexual abuse, but again House proves the consistency of his messed-up ethics by almost praising her – or at least not punishing her, which is pretty close for House - for doing what she thinks is right.
The final diagnosis is a weird one, and House delivers the news in the least empathetic way possible, of course. Alex suffers from male pseudohermaphroditism: according to her DNA, she's a he. (House: "The ultimate woman is a man. Nature's cruel, huh?"). The cancer on her undescended testicle is causing paraneoplastic syndrome (soon to replace vasculitis as the diagnosis of choice) and therefore her variety of wonky symptoms. It also provides some relief from the thought that though she and her father denied abuse to the social worker Cameron insisted on, Alex might not need protection from her father. In one of those lines that makes me a bad person for laughing, House says: "Good news is I don't think Dad's going to be sleeping with him-slash-her again. See, now it's gross."
Through it all, it was easy to forget to credit Hugh Laurie for doing such an amazing job of reflecting pain with every crease of his face, every movement, every catch of his breath. It was easy to forget it was a performance, one so visceral, I felt a sympathetic gut reaction to his pain. Hey, I was just like the clinic patient who was experiencing sympathetic pregnancy symptoms along with his wife.
There were questions about whether both patients and House are experiencing psychological or purely physical symptoms, and we get the answer – only House's worsening pain is in his mind. The episode provided a different kind of discomfort with a scene of pain-wracked House's pathetic plea to Cuddy for morphine to ease the pain. When she refuses, he pulls down his pants to show her his scarred, hollowed-out thigh, and asks if that's all in his head, too. Poor self-deprecating Laurie seems to be caught in contract hell where he's suddenly required to show some skin in each episode, but there was nothing sexy about this reveal, just desperation and pain. House's psychological pain has always been part of the mix, but now he's faced with the proof of it – and the possibly more painful proof that Wilson was right - when Cuddy later admits that the injection she gave him that seemed to cure the pain was actually saline, a placebo.
Though House is an anti-social misanthrope, he's also oddly reliant on those around him. We saw House's "lackeys" take care of him when he induced the migraine last episode. Wilson takes care of him this episode by urging him to recognize the truth, and giving him an MRI to see if there's something physically different about the leg (and even entertaining him with juvenile humour while he's stuck in the MRI tube). But Cuddy appears to be tapped out of sympathy, telling him: "You're on the road to becoming a junkie." It's another disturbing layer to a disturbing episode, where clues we've been given about his pain and drug dependence being psychological as well as physical come together in a revelation not so much for the audience, but for House. And like the best revelations of the show, it doesn't solve a mystery so much as it introduces new issues.
The writing credits this week were more cluttered than the usual "Written by X," with a story by Russel Friend and Garrett Lerner and teleplay by those two plus David Shore. That's mystifyingly messy enough for me to have taken the lazy way out and not mentioned the writers this week, except it also marks the first time this season that creator Shore's name has appeared for episode-writing credit (though his fingerprints must be all over the scripts anyway, of course). And why do I feel the need to devote a paragraph to that? It's the first time his name's appeared since last season's Emmy-winning "Three Stories," and I'd begun to think he would pull a Harper Lee – write the perfect work, then shrug off the pressure to top it by never writing another one. Well, if you ignore the fact that Shore has a resume full of other works while Lee started and stopped with To Kill a Mockingbird. Well, and that she wrote a few minor essays afterwards. But using bad math, Shore only has about 1/5 of a writing credit on this one. Give me a break, I'm not as good at this analogy thing as House.
House returns March 7 with a new episode, but I don't. The next review will be several days late, unless I overcome my completist mentality, succumb to laziness, and (gasp) skip a week.
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(Cross posted to Blogcritics)
