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TV Review: House Gets a Transplant

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What's the differential diagnosis for a TV show that ended its third season with spectacular ratings, having earned an Emmy nomination for Outstanding Drama as well as positive reviews from critics and fans?

Sounds healthy to me. Even Dr. Gregory House wouldn't try experimental treatment on a healthy patient, would he?

David Shore would. In the show's fourth season, the House creator and his writers took the ratings-blessed, award-winning show and gave it the equivalent of a bone marrow transplant.

Like his character's weekly antics, Shore's bold move has paid off. This season has started stronger in the Nielsen ratings than the last (and even stronger in Canada). Creatively, the exodus of Foreman, Cameron, and Chase and the inspired lunacy of House Survivor has reinvigorated a show I wouldn't have said was lacking vigor. However, after three seasons of the three fellows doubting everything their boss said, it was time for them to grow as doctors, and for the show to grow from its confined world.

Instead of hiring replacements for his team, House hired a roomful, creating a competitive game where the winners get their dream job. The first three episodes of the season have both introduced fresh blood and allowed us to see Dr. House through their eager eyes. He's exploring favourite philosophies of life and death, right and wrong, through patient stories with heightened emotional content. Occasionally the humour has felt flat to me (I didn't enjoy the guitar-napping as much as I thought I should, for example), but Hugh Laurie, Robert Sean Leonard, and Lisa Edelstein seem to be having a lot of fun with their  new freedom. 

Since the surprising season three finale, I was giddy at the prospect of having no idea what was in store for the fall, but felt some trepidation that, like plot arcs past, the show would quickly end up back where it started. Given recent news, I don't think that anymore.

While upending the familiar dynamic of the team, the early days of season four can also be seen as a justification for the formula to date. "Everybody lies" is by now a T-shirt-enshrined catch-phrase (literally), but Shore and Peter Blake found a way to build an episode around it in a uniquely poignant way that ended with a clear rationale for why Dr. House cannot work alone. Though he solved the case alone in the season premiere "Alone" — and was right all along, just on the wrong patient — the episode focused on his sounding-board method and exposed his need for others to inspire his brilliance and temper his weaknesses. Not that he'd admit to having any.

"Cameron would never have accepted that this guy knew nothing about the love of his life," Cuddy pointed out. "And as soon as you claimed it was multiple conditions, Foreman would have done anything to prove you wrong. And then Chase would have done anything to prove you right. Any one of them would have solved this days ago."

As I reeled a little from the previous revelation that though House's patient would survive, the patient of the week story had ended tragically, her words re-framed the episode yet again in terms of abject failure.

It's not the first time we've seen that this most anti-social of men relies heavily on the people around him. In the absence of his original team, Wilson has been even more watchful over his friend than usual, in a mind games, feed-the-Vicodin-addiction kind of way — in other words, the only way House could accept.
Wilson is convinced House's employee elimination game will lead to him hiring fellows he doesn't like, so that there's no risk of attachment and another broken heart. That interpretation echoes the advice Wilson gave Cameron back in the first season, when she blackmailed House into taking her on a date: "You'd better be absolutely sure you want this," Wilson warned, "because if he opens up again and gets hurt, I don’t think there’s going to be a next time."

Is he really heartbroken over the departure of his team? Or is that a false assumption on which faulty diagnoses can be built? As usual, the writers cleverly offer an explanation that puts House in a more sympathetic light, while allowing House himself to insist on the less vulnerable option. The show makes us decide for ourselves … and then reminds us of his selfish bastard tendencies, like neglecting the dying patient of "97 Seconds" in order to empirically prove the absence of an afterlife (and proving that House had doubts himself).

House may say he doesn't want to die, but as Wilson claims, he doesn't seem to care if he does. Usually, though, he cares whether his patient does and will do anything to prevent it, which is hard to do unconscious in a hospital bed. Maybe that's good news, in a way; perhaps House doesn't understand the real impulse to die, which is why he missed it in his medication-avoiding patient.

Though he's energized by his new human toys, House has been distracted by his usual excesses with no ducklings following his every move to rein them in, and no one is yet close enough to the case or to House to catch the personal patient details he often overlooks. 

There are some standouts for me in the pool of remaining fellowship candidates, though I wish I didn't know the news I linked to above and could actually play "wonder who's sticking around."

Impossibly old fraud Henry (Carmen Argenziano) is the one House says he'll miss most of all, back when he thought he was fired. I wouldn't go that far, but he's one of my favourites, too. Even after discovering he'd never been to medical school, House couldn't crush his dream any more than the astronaut patient of the week's (if we accept Cameron's more sympathetic explanation). Though House won't hire the non-doctor as a doctor, he's enough of a rebel to overlook Henry's medical credentials and give him a shot at being part of the team.

Call me crazy, but I enjoy Anne Dudek's Amber, the cutthroat bitch who only needs a limp and a sense of humour to be more likable, and who is baffled at the thought that House thinks cool ambition is the most compelling reason for someone to save his life.

Kal Penn is adorably crafty as Dr. Lawrence Kutner (hmm, that name sounds strangely familiar), the doctor who refused to be fired and earned House's respect by suggesting the non-respectable diagnostic tool of tequila. And Olivia Wilde (cool last name, but she spells it wrong) plays 13, the enigmatic candidate House hasn't been able to reduce to an epithet, but whose unflappable exterior flapped in "97 Seconds" after she contributed to the patient's death.

Besides a demonstration of why House needs a team, the early episodes also demonstrate why House needs a Cuddy. Foreman's new – and now former – boss makes an appearance as the anti-Cuddy (played by Kathleen York, who sang the lovely "In the Deep" from "Autopsy" and Paul Haggis's Crash, and worked with both Shore and Haggis on Family Law).

Heading his own diagnostic department, Foreman can't fight his natural House-like tendencies for long, and is fired with nearly the same words he's used against House in the past. If all doctors acted like Foreman, his boss says, the hospital would be full of dead patients: "You confused saving her life with doing the right thing."

In "The Right Stuff," House is completely candid with Cuddy about why he can't be candid with her. When his patient is scheduled for surgery, but whose real treatments can't be charted or her NASA dreams are over, he wins Cuddy over with the explanation that he's acting in the best interests of the patient. He explains that his rationale will make sense to her, but not to the disciplinary board or judge, so she's better protected if she doesn't know what he's doing. Not surprisingly, she steps aside. Cuddy is enough like House to continue employing him and letting him get away with unconventional to downright unethical methods, but is enough the responsible hospital administrator to make her own life miserable while she tries to make his difficult.

The troika of House, Wilson, and Cuddy has always been the centre of my House world anyway, but I can't say I've missed the original recipe ducklings during their reduced screen time, what with the intriguing new personalities the show has introduced. I wasn't crazy about Chase as deus ex machina in "The Right Stuff," but for the most part, the way Foreman, Cameron, and Chase have been integrated into the stories so far has made me hopeful the series can effectively juggle even more characters and not completely reset once the unconventional hiring fair is over.

It was risky for a show at the top of its game to go forward with a potentially game-changing storyline like House Survivor, and we're not talking about a fictional patient who might have suffered. But so far, vital signs look very good.

House takes a break this week, but returns next Tuesday, October 23 at 9 p.m. on FOX, or Global in Canada.

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About Diane Kristine Wild

Diane travels. She doesn't tan.
  • Judy

    I have missed you this season. So glad you did this review. You are so good at your reviews and always point out things about the characters in the episode that I miss. Hope you’ll stick around and keep reviewing for us. You are awesome!

  • Great insights, Diane, as always. Agree that Shore and co. were very right to mix things up at this stage of the game. I do so love the drama, Hugh Laurie, and House that I’m eager to see where they go next with this. Am enjoying the tone of extreme!House at the moment, but hope that some of the broader comic pieces (the guitar-napping, the Survivor tribal council) give way to more subtle efforts. Hope you continue to write about House. (Enjoyed your piece about honorary canuck House, eh!)

  • EC

    I enjoy your commentary, but I wholeheartedly disagree that the show has been invigorated. I think it’s been dumbed down by playing up reality show nonsense. I think the introduction of new characters is a cheap gimmick to save the writers from actually having to explore and flesh out the characters we already care about. I find Chase just as interesting and compelling as House–only with room to change and grow. The only scenes from the last two episodes that even felt authentic were the scenes with House and Chase. The first episode was boring. The second episode was scattered and left me wondering what show I was watching. The third episode highlighted just how ridiculous and dangerous this “game” is (given the outcome). The show was working just fine the way it was and it’s a disservice to the viewers who have put it where it is to sacrifice half the cast by reducing them to nothing more than bit parts. I am thoroughly disappointed with the turn House has taken and I hope they eradicate this mess by bringing back Chase, Cameron, and Foreman in full capacity.

  • Thanks guys! I always planned to dip in and out so I’ll be around, Judy.

    EC, I couldn’t disagree more, but your (obviously completely valid) opinion is exactly why I think the shakeup was so gutsy, and I’m so grateful for it. Of course there will be fans who don’t want the show to change, and that can be a great excuse for writers or a network to let a show stagnate.

  • EC

    I believe that a show can go on for years with the same cast of characters without stagnating if the writing is excellent. Frasier comes to mind–excellent show popular with both fans and critics, no major changes to the core cast over the 11 year run. Better storytelling IMO would be to flesh out the characters that they already have an audience invested in instead of alienating part of the audience by failing to utilize the chemistry that has made the show the success it is.

  • Oh, you didn’t see the same show (or read the same reviews) I did if you think Frasier didn’t stagnate. We’re definitely on different sides of the fence. I could happily see the ducklings change frequently. It doesn’t even make sense for fellows to have been there as long as they were – early in season one we found out they were part way through 2-year fellowships. I can suspend my disbelief with the best of them, but it only makes the characters look more and more like idiots if they are on indefinite fellowships, never growing professionally.

  • sherlock21b

    While I agree that the Survivor-style storyline has indeed resulted in some rather creative storytelling as a whole, I can’t disagree with you more about the new blood. Except for the absolutely delightful Old Fraud, I keep wanting all the med-testants to get auf’ed(to use the expression of a different reality show). Not one of them is as interesting on their own as the original trinity of ducklings, who were the absolute perfect lens through which one could view and relate to House. Not only are the newbies not intriguing (amber is a two-dimensional version of House without any of his redeeming features), I fear they will get old fast, once the thrill of competition ends. Even Foreman at his worst or Cameron at her most self-righteous is better than what we’ve gotten so far. I shudder to think we’ll get less of them to make room for second-rate characters.

    What is worse, however, to my way of thinking, is the way in which they’ve dumbed down and sexed-up (what is with her clothing? no professional woman dresses that way) Cuddy. This is not the confident and professional administrator that we saw in Season 1 (to my mind, still the best season of the show). Kathleen York’s competent administrator was actually all the more damning because she showed just how much Cuddy is willing to kowtow to her rogue and ignore his antics. Granted, that would make the show more problematic, but still.

    Change does not always mean improvement, and following a successful formula does not always lead to stagnation. The key is in successfully integrating new features into the whole. I’m reserving judgment until I see how this experiment ends, but for now it’s problematic for the producers that the most memorable scene of the season so far was Chase telling House where to stuff it.