What's better for a medical show than a child in peril? Two children in peril!
We meet the family of "Family" in the teaser, when Wilson is preparing mom, dad, and youngest brother Matty, who is going to donate bone marrow to his leukemia-stricken brother Nick … until a sneeze timed for maximum dramatic effect puts that in question.
Post-teaser, we get a family of a very different sort, as House wakes up to his new furry housemate, Hector. Who would have guessed, but House shows remarkable rage control as he surveys the chewed sneakers and books, and picks up his sopping cane before escaping to his other family. Though if Wilson thinks House and his team are family, I can only imagine what his dysfunctional frame of reference is.
The gang congregates in the chapel, where Foreman is apparently trying and failing to find solace after killing last week's patient. House tries and fails to contort the needle in the haystack cliche to explain why they need to make Matty's infection worse in order to pinpoint what's causing it. Because just to twist the knife embedded in Foreman a little more — to use another cliche — the diagnoses this episode are similar to last. Infection? Auto-immune? Who's to know. And he feels the need to really know this time.
Foreman isn't thrilled with House's idea and proposes the usual house search for contaminants, which House isn't thrilled with, since they have all the evidence they need in their patient's body. He also sees Foreman covering all possibilities as a sign of weakness. The parents, not surprisingly, are not thrilled at the idea of making their supposedly healthy kid sick in order to treat the definitely sick kid. House is not thrilled that Wilson didn't manipulate the parents into agreeing to the idea, risking a no for the comfort of being the good guy. To sum up: no one is thrilled, though the parents do agree.
It's kind of sweet to see not-always-friendly Foreman and Chase search the house together, commiserating over their respective fatal mistakes — Chase's way back in season two's "The Mistake." Chase is on a strangely sweet kick lately. I wonder what that's a symptom of? However, Foreman takes little comfort in their shared history, since Chase had been affected by his father's death, while he made a calculated decision. "You acted like a human being. I acted like House."
Foreman's always been troubled by any suggestion that he's like his boss, focused on the case rather than the patient, but if even Cameron's getting less interested in the humanity that comes across their whiteboard, there's not much hope for Foreman. Though the fact that he cares that he might not care means he hasn't been completely subsumed by his boss's personality.
Foreman informs House about a new symptom for that whiteboard, which should narrow down the search for the type of infection:
Foreman: He has acute scrotum.
House: Adorable, please, much more dignified. [Pause] Come on, how am I not supposed to make that joke?
Foreman wants to recheck the donor registry as a backup plan, in case they can't solve the mystery in time. Them's fighting words to House, but he lets Foreman go without a fight, while Chase and Cameron discover Matty's heart has been affected. Plus, being Tuesday, Chase the multitasker reminds Cameron again that he's available and interested in her. It was hilarious last week, but this could get old fast.
House is delighted with the news that they've caused Matty to have a heart problem. "OK, perfect is too strong a word," but it means they can remove the heart valve, identify the infection, and cure the infection in his bone marrow before putting it in his brother.
As part of his new ultra-cautious MO, Foreman goes to Cuddy, who, unlike House, values Wilson's diplomatic and truthful approach to patient consent and leaves it to Wilson to make sure the parents know the options. House also lets Cuddy know that the reason he's cutting Foreman slack is that, like Nick, he has four days left. If he isn't cured of "the yips" (I had to Google to make sure I heard that right –I hate sports metaphors), his loss of confidence, he's fired. And, he says, no one gets cured of the yips.
The parents in this episode — whose names I don't remember, don't even know if they had names, so unessential were their personalities — are faced with more ethical dilemmas in an hour than most people in a lifetime. They choose to let Matty undergo open heart surgery for the chance to cure Nick, but don't let their youngest son know the consequences, that he'll be permanently limited physically by the operation, a consequence House scoffs at because it's not limiting enough to be considered crippled. While I was busy being horrified that Matty went into surgery ignorant, Cameron made a fair point: a 10-year-old shouldn't have to make that decision.
Wilson advises them to protect their family as a whole, getting them to agree to the surgery, and House's influence spreads yet again. Except Wilson actually cares that he's betrayed the trust of the parents, as demonstrated in my favourite exchange of the episode:
House: You've got to be kidding me. You're actually upset. You just said what you believe.
Wilson: I also believe in patients making their own choices.
House: Because it lessens your guilt if things goes wrong. You're not protecting their choices, you're soothing your conscience.
Wilson: By that logic a sociopath would make the best patient advocate in the world.
House: Am I blushing?
Only the operation doesn't go ahead as planned, because the heart valve isn't infected, and there's something else going on. Auto immune? Foreman doesn't wait to figure out what that something else might be and approaches the parents about a partial match from the donor registry, which they accept despite the danger of graft versus host disease.
Surprisingly, Wilson is livid and House is not, because Foreman did what he thought was right, and that's one trait House admires. There's that unexpected rage control again. Though just prior to finding out, he had begun to try to kill his new dog, so perhaps it's just passive-aggressive rage.
It becomes aggressive-aggressive rage when directed at Wilson, though. "What is the point in being able to control people if you won't actually do it? " House yells at him, mad that Wilson wouldn't lie to the parents to counteract Foreman, and allowing Robert Sean Wilson to demonstrate the face of "where'd that come from?"
House apologizes not very sincerely when he calls Wilson in to pay for a new cane, replacing the one Hector has chewed through, causing House to collapse in a heap. "You called me a coward, life goes on?" Wilson asks. "Apparently. You showed up," House replies reasonably. If you don't want to be taken advantage of, Wilson, you might want to grow a spine.
House rejects the Marilyn Manson in a retirement home cane, as well as the bull penis cane. As any undergrad linguist can tell you, Noam Chomsky's "creative aspect" of language means we can string together words into sentences we've never heard before, sentences that have never in the history of human utterance ever been uttered. Such a sentence can be found in the cane-shopping scene: "Penis canes are murder."
Instead, House picks one with racing stripes, allowing Hugh Laurie to make his "Bitchin'!" face, and strolls into the hospital to a rock anthem and stylish directorial moves. Once there, he finds that Nick has graft versus host disease that's unresponsive to treatment, will certainly die, and Matty is bleeding out of his ears, headed for death himself. Not so bitchin'.
House's new audacious – some might say crazy – plan is to put the infection into Nick so they can see the symptoms speeded up, and diagnose it before he dies, allowing them to save Matty. But this time, Wilson's powers can't control the parents, and no matter how much he tries, he can't convince them to go along with the idea of killing one son to save the other. They won't give up on Nick.
House shows his not-too-shabby powers of manipulation that even Wilson couldn't go along with when he gets rid of dad and confronts a painfully dying Nick, telling him how his life can have meaning by saving his brother. That's low, even for House, but on the other hand, he's doing the math, as usual. Anything to get the best outcome for the case, patient rights' be damned. Nick then pulls every heartstring by pleading with his parents to let him be the guinea pig who will save his brother.
Foreman and Wilson chat amicably but at cross purposes, Foreman still trying to narrow down the infection, Wilson trying to warn him that his job is in danger, and advising him to quit if he doesn't care about his job, fight for it if he does. It seems like Foreman isn't listening, but like Chase, he's a good multitasker. So is Wilson, because he gets the epiphany that's usually reserved for House. The family's house was built over farm land, and chicken manure seeped into the soil, causing a nasty but curable infection.
The parents get the good news that Nick doesn't have to go through with it and Matty can be cured, while getting the bad news that he won't have enough marrow to donate safely.
In a parallel scene to House and Nick, Foreman asks Matty if he'll risk his life to save his brother. Is he fighting for his job after Wilson's pep talk, or has he cured himself of the yips? Probably both – welcome back Foreman. What follows is a horrifying scene of Foreman extracting bone marrow with giant needles into the unsedated boy while he screams in pain. I'm not good with blood; I'm horrible with screaming in pain. Do I love my brother that much? Sorry, Steve, but I'll have to get back to you on that. I wish I could erase that scene from my brain. But, it worked, and the family of four who entered the hospital will leave as a family of four.
The easily-forgiving Wilson continues his attempt to act as House's conscience, encouraging him to tell Foreman he's proud of him. House dismisses the idea that pride and shame have any place outside the family. "How many hours a day do you have to spend with someone before they're basically family?" Wilson asks. I hope my boss never makes me call her "mom."
In my favourite line of the episode, House retorts: "First I gotta tell Cameron and Chase that they're violating God's will."
Since ex-Mrs. Wilson can now have dogs in her condo, so Wilson takes him back, before making sure House really wants to give him up — the dog he's spent the entire episode trying to kill, only to turn him into a limping Vicodin addict. No wonder Wilson thinks he's another victim of Stockholm syndrome, and no wonder House recognizes a kindred spirit in the cranky dog.
Despite dismissing Wilson's suggestion, House does give Foreman a pat on the back. Maybe the puppy did make him a softie. Maybe he's doing anything to preserve his "family," even swallowing his pride and having the unnecessary conversation.
Throughout the episode, House has harped on the need to do what's right, by the idiosyncratic definition of doing what will provide a successful outcome to the case. Foreman, though, isn't feeling good about torturing Matty, and especially for not questioning his decision with the kid screaming in pain under his hands. As always, he's conflicted about his ability to shut off his humanity during a case, and as always, House can't see why that's a problem.
Foreman: I hate that in order to be like you as a doctor I have to be like you as a human being. I don't want to turn into you.
House: You're not. You've been like me since you were eight years old.
Foreman: You'll save more people than I will. But I'll settle for killing less. Consider this my 2 weeks notice.
I have a bet resting on whether Foreman's actually gone for good or not. I say not. My opposition says they can't go down this "I'm quitting"/"No I'm not " road yet again. I'm not sure what I'm going to win, though — I've got until the end of the season to decide. Ooh, cocky. House is even rubbing off on me.