The fundamental question posed by the series House, M.D. since its first year concerns doing the “right” thing. In House’s (Hugh Laurie) world, doing the right thing doesn’t always mean doing the expedient or safe thing. It often requires stomping on the rules, ignoring protocol and taking risks both with the patient’s life and with the careers of all doctors involved in the case.
In the season two episode “Deception,” Dr. Eric Foreman (Omar Epps) frames House’s modus operandi as medical anarchy—an approach that will someday lead to someone getting killed. In this week’s episode “Nobody’s Fault,” House is investigated do determine the blame for a incident in which Chase (Jesse Spencer) is nearly killed, and from which his recovery will likely be slow and painful (emotionally as well as physically).
Pursuing Adams’ (Odette Annable) diagnosis—something with which House disagrees, Chase plans to grab a small sample of a rash on the patient’s body. Prepping the patient for the biopsy scalpel, Adams triggers a psychotic break caused by the medicine given him by House’s team. As Chase tries to handle the quickly escalating situation, the patient grabs a scalpel, stabbing him in the chest.
How could something like this happen, wonders the doctor assigned to investigate and assign blame. Foreman brings in his old mentor Dr. Walter Cofield (Jeffrey Wright), who interviews everyone involved to ascertain whether the chaotic atmosphere created within House’s department has inevitably led to tragedy.
Ultimately, it is not House’s sarcasm, his lack of patient contact, or even his Vicodin use that is the issue; it is the chaos that surrounds his diagnostic process.
There is a season four episode called “97 Seconds” in which the patient dies because of simple human error, but error made a thousand times more likely due to the chaos fed by House’s fellow-hiring games. House would argue that his methods do sometimes lead to bad things happening, but he does the math, and although he may lose an occasional patient, House’s track record for saving patients that other doctors have dismissed as lost causes is pretty astonishing. But does his success make it right? Should House be allowed to continue practicing medicine the way he does? Or does the risk outweigh the possible benefit? And that’s never been directly challenged in eight years of House episodes (except tangentially so in “The Mistake”).
Ultimately, fueled by the knowledge that House has saved a patient’s life, Cofield concludes that although House’s methods are dangerous, they are too effective to simply ignore. The case is decided as “nobody’s fault”; House and his team are absolved of wrongdoing. But in an interesting turnabout, House refuses to embrace this conclusion. Is he just being defiant, or is there something deeper going on as he berates Cofield for being a coward in declining to assign blame—to anyone. It is almost as if House is disappointed that Cofield hasn’t recommended action against him, which would have sent him back to prison. But despite the finding, Chase, Adams and House will all have to live with the emotional fallout created by a tragedy that was “nobody’s fault.”
Had there been no investigation at all things might be easier for all three (and Foreman) moving forward. Chase should never have approached the patient scalpel in hand; he simply wasn’t thinking, feeling the need to react quickly. House would have chalked it up to a no-fault, but potentially tragic, accident. He never would have attributed Chase’s decision to biopsy the patient’s rash not to defiance, but as initiative.
But, the investigation happened, and each of the three main players has to live with the consequences—decision of “nobody’s fault” or not. Adams will lose a lot of sleep wondering if her decision to ignore House in favor of her own and test the patient for invasive strep has indirectly led to Chase’s injuries. I’m sure she’ll be plagued by doubt, and perhaps lose her nerve the next time she thinks she has a better idea than her boss—even if she’s right. For the moment, Chase is dealing with the physical consequences, struggling with walking, but he, too will likely begin to wonder how much of what happened can be linked back to the way House’s team operates.