Every time this "Whac-A-Mole" episode of House started to annoy me with little character moments that didn't make sense to me, up popped scenes with big character moments that made me happy.
Patrick Fugit of Almost Famous is great as pragmatic, dryly humorous 18-year-old Jack, surrogate parent two his two younger siblings since their parents were killed in a car accident. Jack gave some kid a birthday to remember when he threw up on the presents during a shift at a kiddie-themed restaurant, then had a heart attack and the slightly lesser symptom of itchy feet.
Always game to make his own fun and to show off his unusual teaching methods, House seals his own answer in an envelope and challenges his team to come up with the diagnosis on their own. After all, as he points out, how will they learn if he doesn't let them swim on their own? But of course he doesn't, really, because that would mean shutting up. And where's the fun in that?
About 15 minutes in, Foreman, Cameron and Chase are miraculously provided with the results of a Hepatitis A test they didn't order, and the Hep A explains the puking, which caused the heart attack. Which seems a little prosaic for the lofty department of diagnostics, but since it comes only 15 minutes in, it's safe to say that's not the end of the game.
When Cameron opens the envelope, she finds it contains not the diagnosis of Hepatitis A, but the diagnosis of how Foreman, Cameron, and Chase would react, proving House's diagnostic skills work on personalities and not just diseases.
Fortunately, Jack's Hep A is curable. Unfortunately, his sudden propensity to bleed out of every orifice, and some non-orifices, is unrelated to the original diagnosis.
Though David Morse doesn't appear in this episode, Tritter's shadow does. Wilson, apparently a fan of LA Law, Chicago Hope, and maybe even The Guardian, picked Alan Rosenberg to be his lawyer, who grills him about the forged prescriptions.
Wilson: What, are we, like, role playing?
Lawyer: Yeah, and you suck at it. Which is really unfortunate, because you're pretending to be you.
Long-lost Marco the put-upon pharmacist has to break the news to Wilson that he can no longer prescribe, which puts a hamper on the cancer doctor business. Tritter has taken a page from the Evil Board Chair Vogler playbook, getting at House through destroying Wilson's career, though my feelings of deja vu were counteracted by later revelations that this time it's playing out differently.
Chase stands up to House, refusing to write him a Vicodin prescription ("I'd rather lose my job than lose my license") and Cameron stands up to Wilson, refusing to simply write his prescriptions without meeting his patients. She's a little more clever than Chase, who doesn't point out, as Cuddy does later, that one of House's employees writing the script would simply prove Tritter's point that House exerted his influence, making it worse for House. Cameron reasons with Wilson that while she trusts him, Tritter is going to make it hard on both of them if they don't do this Cameron-as-Wilson's-prescription-proxy thing by the book.
We get a scene of a patient protesting Cameron's presence in the exam room, and I felt like there was a missing piece there, either in the episode or in my brain. Sure, we get the message that it's awkward for Wilson to have Cameron shadowing him, but of course it is. Plus I got that from the scene prior, where she demands to examine his patients against his protests. Even Wilson the bad liar should have been able to come up with a better cover story. Isn't she still supposed to be a fellow? Couldn't she be learning about his specialty? And up popped up the reason to let it go - that's the point, I suppose, that Wilson is really that bad of a liar.
Foreman tends to the patient with the assistance of little sister. He assures her Jack's not dying when she explains her parents died suddenly and implores "I would just like some warning this time." I'd think even House would melt at the sign of that wobbly lip and welling eyes. But maybe not this episode.
Foreman humours her by getting her to hold Jack's knees while he injects the drugs into his spine. "Is this all nurses do?" she asks, leading Foreman to explain, "Dr. House doesn't trust them to do anything else." Ooh, I smell more protests against this show's no-nurse zone.
House's aching shoulder gives us the priceless scene of Hugh Laurie finally delivering the line onscreen that, yes, the show realizes House uses his cane on the wrong side. He's House. Of course he does it his own way.
Physical therapist: Ever thought about using your cane on the proper side?
House: Yeah, that's the issue. Friday night, my cane finally noticed it was on the wrong side.
This episode felt like it contained one too many winks at the audience, but then I likely only have that perception because I've been saturated with the nitpicks and assume the writers are winking at them. Maybe they just have something in their eye.
It seems the team knocked out Hep A, but then osteomyelitis, botulism, syphilis, and whatever Cameron was testing for popped up. "I think this game is rigged," says House.
House decides the shot immune system must be drug-related, and gets the team to sweat the toxins out of Jack so they can test him again. That leads to an odd but visually funny scene with all three lackeys getting into the sauna with Patrick in full scrubs, where they talk about Patrick's disbelief in god.
House seems to have lost some of his manipulative magic, since it doesn't work on Cameron either. "Tritter wants to win by giving pain. You really want to be a part of that?" She tosses him some ibuprofen (or something): "It takes the edge off my PMS. Should do wonders for you." Girl, there's no case of PMS in the world as big as that.
Drugs aren't the answer, and Patrick's brain tumours - or fungus, as it turns out - means Foreman is getting closer and closer to lying to little sister about Jack being far from death. He also gets closer to calling House a hypocrite - about the case, but there's shades of the legal mess too.
Foreman: House, you're pathetic. You'll analyze anyone's faults, hypocrisies, weaknesses, but this kid's got some strength and all of a sudden, there's no time to talk about anything but the medicine.
House: He's teaching prepubescent kids that truth matters, god doesn't, and life sucks. I like him.
Foreman: I know the notion of self-sacrifice is foreign to you ...
House: You want to think that he's sacrificing himself because if one person can do it, then maybe the world isn't the cold, selfish place you know that it is.
Cuddy writes House the prescription, finally, since she needs to prove that Tritter's wrong, and House does need the drugs. This was another moment of annoyance for me, since this season seems to be proving that House's pain is completely in his head, and if so, everyone else is even more guilty of enabling than when we thought the leg actually caused the pain. I feel a little let down that the concept of his pain isn't as complex a mixture of physical and psychological as we were led to believe in the first couple of seasons.
Cuddy also notices his bum shoulder, and speculates that that's in his head, too. What's changed, she asks? "Fight with the wife, maybe?" Bingo - it's the conflict with Wilson causing it. "It's good, it means your shoulder is a human being, anyway. It's a start." His shoulder might realize that Wilson is actually doing a pretty good job of that self-sacrifice he doesn't want to believe exists, and he's not doing such a good job of sacrificing himself, despite the fact that Wilson's efforts are a result of House's blatant crime. House is good at diagnosing people other than himself.
But House's bingo moment has nothing to do with himself and everything to do with Jack. The epiphany seems pretty forced, but House decides the emotional pressure of life without the parents has forced Jack's illness to come out of hiding, so the sudden onset of a genetic illness is no longer unlikely. While they brainstorm, House refuses to let one of his minions off to help Wilson with his prescriptions. Wilson forgot to frame it in a way that would make it all about House and the benefit to him.
The solution is to expose Jack with four different infections to monitor which one he picks up first, and therefore identify the disease that's most susceptible to that infection. Shockingly, that diagnostic method is not FDA approved, but this isn't an episode where Cuddy or one of the minions decide to care.
Once they have their final diagnosis, it's up to Jack to accept the treatment - a bone marrow transplant from 8-year-old brother Will. Jack refuses on the grounds that it's too dangerous for Will and does a drive-by mention of the issue of consent, which wasn't provided for the blood test in the first place.
House decides Jack's copping out, choosing to remain sick so he doesn't have to deal with his crappy life. Foreman refuses to believe Jack believes his life is crappy.
House: Moronic. [Pause.] It's a synonym.
Foreman: Why can't you accept he wants to protect his brother?
House: He has to protect his brother, he doesn't want to. He want to run screaming from protecting his brother.
Foreman: You're a hypocrite. Evidence is everything. Truth is all that matters. Except when it comes to people. Everything we've learned about this kid says you're wrong. But you can't accept that. It's easy to reject the diagnosis, not so easy to reject your misanthropy. Because then you'd have to give people a fighting chance. And that scares the crap out of you.
The end result is that Foreman goads House into goading Jack, who snaps and admits in actions and words that the pressure of being a surrogate dad is influencing his decision to refuse the treatment. ("Don't pretend you're surprised," House says to Foreman.)
As Foreman implies, we have a choice to be misanthropic or not. A choice to do the right thing or not. A choice to take responsibility or not. Guess which way House chooses? He visits Wilson's office, where his friend is packing his things and packing in his oncology practice because of Tritter's actions.
House: What, do you want me to turn myself in?
Wilson: Yes! Yes! Do something. Go in, show some remorse, tell Tritter you'll get some help.
House: I don't need help.
Wilson: House, get out of here. Get out of here.
House: You're not going to make me feel guilty for what Tritter has done to us.
Wilson: You already feel guilty. Your mysterious shoulder pain isn't coming from your cane, it's coming from your conscience. That used to be enough. Despite all your smart-ass remarks, I knew you gave a damn. This time, you were either going to help me through this or you weren't. And I got my answer.
After that emotionally charged scene which pretty much absolves this episode from my occasional annoyances with it, Jack tries to put a positive spin on foster care for his younger siblings while Foreman looks on. When they leave, he predicts Jack will take them back in a few months and be proud of himself, and his parents will be proud of him. "It's what I want to believe," Foreman says. It seems House is right. Foreman doesn't quite think the world is a better place than House does, but he wants to.
The episode ends with House driving past Wilson, whose car was impounded by Tritter, at the bus stop. He pauses, makes eye contact, then drives away without a word. Whose life is crappy again, House?