I love this show's episode titles - short and simple, yet prone to multiple meanings. House has so often told us "everyone lies" that I couldn't see this one without instantly thinking, even sleeping dogs. Ha. But, I thought, of course they mean that some secrets should remain dormant. So maybe I should feel a little foolish that I forgot about the title when an actual dog was introduced into the mix, and didn't see its crucial part in the diagnosis coming. Instead, I'll credit the show with being just that clever.
Last week's episode left me feeling like I didn't have enough to chew on. This week's perhaps gave me too much - settle in for a longer read than last time - as it waded into the murky ethical waters I love so much. We're treated to dilemmas in both the medical story and also the character story, and I don't know what I've done to deserve this.
In a frenetic pre-credits sequence that's directed and cut like a horror film (direction courtesy Greg Yaitanes, whose name seems to pop up on every show on the air right now), we're introduced to sleepless Hannah, our patient of the week. Her girlfriend Max calls an ambulance when she finds the desperate woman, still awake, in the bathroom after having taken a bottle of sleeping pills. Cuddy finds House sleeping in an exam room - no subtle juxtaposition there - and lures him onto the case with that news on top of the fact that Hannah hasn't slept in 10 days. And, in case we were going to dismiss her as a whiny insomniac, Cuddy points out that the longest anyone has survived without sleep is 11.
They subject Hannah to various tests and rob her of the seconds of sleep she has been getting in order to stress her body even further, trying to prompt a new clue. "We've got rectal bleeding," Cameron informs House as the three minions stride into his office with news of one such clue. "What, all of you?" House counters before ordering them - while popping a Vicodin himself - to perform a colonoscopy on Hannah with no pain medication. (Our favourite oddball drug addict also tries a new delivery system in this episode, crushing his pills and putting them in his sandwich at one point.)
The colonoscopy is a very uncomfortable scene to watch, even though they - oh god, thank you, Mr. Yaitanes - didn't make us watch the actual procedure in much detail. While the woman writhes in pain, before blood starts gushing from her nose, Chase and Cameron set aside their professionalism to childishly discuss one of the ethical issues in the episode: Foreman has stolen Cameron's idea to write about the "Autopsy" case for a medical journal (hey, the Writers Guild agreed it was a good one, too), and his was published first ... because House sat on Cameron's paper as she waited for him to read and comment on it, instead of simply signing it, as Foreman requested.
"You know what happens when you're nice? Nothing," Foreman lectures her, in a lecture she's heard too many times before. House doesn't want to hear about the dispute - "I especially don't care if it was my fault" - and hopes Cameron will lose some of her idealism out of the hard lesson:
House: You continue to be flabbergasted every time somebody actually acts like a human being. Foreman did what he did because it worked out best that way for him. That's what everyone does.
Cameron: That is not the definition of being a human. That's the definition of being an ass.
The other ethical dilemma comes because Hannah, it turns out, has been planning on leaving Max - a fact House deduced from the clues that Hannah claimed to have had an allergic reaction to the dog Max had given her for her birthday, despite the fact that she had been on steroids which should have suppressed an allergic reaction. See, it's not that I didn't know the dog would have something to do with it, I just forgot about it by the time ... oh, never mind. Sleeping dogs and all that.
In a nice - and possibly even intentional - nod to the visual joke in "Failure to Communicate," where House was reading the book Classic Lesbian Prison Stories, we get this exchange:
Cameron: OK, well, we could either base our diagnosis on your admittedly keen understanding of lesbian relationships, or we could do a scratch test.
House: Do a scratch test.
But to buy more time to solve the mystery and save Hannah's life, the team needs Max to be willing to donate her liver. That sets up a semi-predictable alignment of House on the side of keeping the non-patient in the dark, and Cameron on the side of informing her about Hannah's intentions.
"You can't ask the person she's about to dump to donate half her liver," Cameron protests. "Does seem tacky, doesn't it?" House replies before heading off to see the patient for the first time. He is the seemingly honest and direct bearer of bad news: Hannah will die before they can figure out her ailment, because her liver has shut down. Showing his masterful manipulation skills, he gets Max to offer her liver, seeming to mull it over as a possibility before reluctantly agreeing. But, as he exits the room, his expression indicates he's not feeling particularly exhilarated about the success of his ploy.
For me, the most interesting contrast between the soft and cuddly Cameron and the hard and curmudgeonly House is that though he disparages her brand of it, they both seem to be idealists in very different ways. Cameron expects people to do the right thing and is sanctimoniously disappointed when they don't. House expects people to do the wrong thing, but often seems bitterly disappointed when they do.
"Sleeping Dogs Lie" was written by Sara Hess, who also wrote "Spin," where Cameron's ethics annoyed and puzzled me. In that episode, she was willing to break medical ethics in order to expose a breach of a patient's sports-related ethics. In this one, she argues for a greater ethical responsibility. House argues that their knowledge of Hannah's intentions is not medical, and therefore does not breach medical ethics guidelines. There are shades of grey here on both sides, since House is not as single-minded as Cameron accuses him of being. It's not just about finding the solution, it's about saving the patient, and he's looking at the flip side: the unethicality of letting Hannah die when they have the power to save her.
But as Cameron points out, Max the liver donor is now somebody's patient, and she must give fully informed consent before that doctor signs off on the procedure. So House approaches Cuddy. In a scene that gives us a welcome reprieve from the blindly mistrustful Cuddy of last week and too many other episodes, House acknowledges that he needs her assistance, and Cuddy trusts that his risks generally pay off - or why else would she put up with him? House doesn't deny that he has information he must keep from Max, and asks Cuddy not pry into Hannah's file, so she can remain unaware of the non-medical reason that might sway Max's decision.
But when House finds out that Cameron is alone with both Max and Hannah, he realizes she's likely to manipulate them into having that break-up conversation at the worst (if you're Hannah or House) or best (if you're Max or Cameron) possible time. He hurries to the room to sedate Hannah, stopping her in what seemed to be mid-reveal. It's a slight possibility that he also saved himself from the disappointment of seeing her not tell the truth. But more likely, as Cameron points out, he doesn't really believe that people will always do what's best for them, even in a life and death situation, and he thought she would tell the truth. So by knocking Hannah out before she could, he's proving Cameron's point.
The liver transplant dilemma is really the focus of the medical story, but the final diagnosis is the black plague, believe it or not, transmitted by a flea on that puppy Max had given Hannah. House takes the opportunity to tell Hannah that while they can cure the plague, they can't cure being a bitch. Which seems a little unfair, since he robbed her of the opportunity to make things right at the last minute. But not untrue.
In a beautiful twist to the dilemma, Cameron discovers that Max has known all along that Hannah was intending to end the relationship. She figures, however, that it was her perfect opportunity to manipulate the situation: Hannah can't possibly break up with her now that she's saved her life. Or so she thinks, and we don't find out differently. "I love her. I just want her to stay," she explains when Cameron objects that neither one of them could possibly be happy in that kind of relationship. This show has a twisted view of love. I love it.
Cuddy gives Cameron another reason to get over her fury at Foreman: revenge (plus she gets in a sweet dig at Cameron's petulance).
Cameron: You're on his side?
Cuddy: Sides? No, this isn't dodgeball.
Cameron: What am I supposed to do, just sit back and take it?
Cuddy: No, write another article. Kick ass until you're sitting behind some big, expensive desk and someone from Johns Hopkins calls and says "We're thinking about hiring Eric Foreman as our head of neurology" and you can say whatever you want.
Mandarin is added to House's growing list of languages, as he deals with a Chinese clinic patient and her teenaged daughter who acts as translator. She initially says her mother is having difficulty with PMS, and needs birth control pills. House realizes that the mother actually has a cold, so, hmm, who could the birth control possibly be for? He lets SAC (Stupid American Child) know that she doesn't need to lie to get the pills, and gives her prescriptions for both a decongestant for mom and birth control for daughter. When they return, mom's new symptoms indicate the girl may be just as bright as House figured, since she mixed up the two prescriptions. In what I'll take their word was Mandarin, he drops the bombshell on the mom that the daughter is pregnant (which is not true, but has the advantage of getting his point across in the nastiest way).
House does a lot of sleeping in "Sleeping Dogs Lie." Maybe it was a ploy to give the overworked Hugh Laurie some well-deserved rest, but it gave an added dimension to the theme of the episode, too. House's theory is to let the backstabbing and bickering of his underlings lie, showing, as in the whole Vogler the Evil Board Chair mess of last season, that he is truly inept at office politics. And, possibly, proving Wilson's argument that he may not be the best teacher, either. So while his excuse for sleeping on the job is the continued annoyance of early bird Wilson as a roommate, it's also a representation of how House is figuratively sleeping on the job. Foreman, Chase, and Cameron are supposed to be on fellowships, learning under House, and while we see flashes of the brilliance of his unorthodox teaching methods, we just as often see his admitted laziness at work.
The final scene is either Cameron taking Cuddy's advice and pretending to bury the hatchet, or Cameron holding steady as the "everyone must like me" girl and actually burying the hatchet. She confronts Foreman to apologize and demand a reciprocal apology - which Foreman refuses to offer - when the camera pulls back to show House on the other side of the glass, snoozing in his office. We haven't heard the last of this spat, or, I hope, House's responsibility for it.
On an unepisode-related note: As you might have noticed from my fascination with who wrote which episodes, and occasional mentions of the directors and other off-air talent, I am a compulsive credits watcher and behind-the-scenes junkie. So why did I not know House's apparently non-writing executive producer Paul Attanasio wrote the Oscar-nominated screenplays for Donnie Brasco and Quiz Show? Someone didn't send me that memo. (It's not there yet, but check the Emmy site to see if they put up a download of the webcast or at least a transcript of yesterday's Evening With House event, where among many other interesting exchanges, fellow executive producer Bryan Singer, whose name also contributes to the show's impressive pedigree, raved about Attanasio's writing. I thought he might have gotten him mixed up with David Shore, but it turns out the guy who thought Hugh Laurie was American and Jennifer Morrison the blonde was a different person from Jennifer Morrison the brunette did know the difference between "Paul" and "David.")
I suppose I can't know everything. I do know the next episode airs Tuesday, April 25, at 9 p.m. on FOX or Global in Canada.