"Insensitive" could really be the subtitle to this entire series. House, M.D.: Insensitive Bastard has a nice ring to it. Too bad they've already got the billboards printed with plain old House.
The episode title, however, refers most obviously to the patient of the week, bratty teenager Hannah Morgenthal, born with a rare condition called CIPA that makes her unable to feel pain or regulate her body temperature.
And House, who is disdainful of everyone, superior to everyone, finds himself, you might say, hypersensitive: jealous of his patient and of Cuddy's date.
The jealousy is at first hilarious rather than heartbreaking. Hannah comes to the hospital after a car accident has seriously wounded her mother and possibly wounded her – but who can tell, when she doesn't hurt, won't let them examine her for internal injuries, and refuses to admit she has CIPA.
Foreman doesn't buy House's instant diagnosis, even though the first of his several reasons – she denies she has CIPA without ever asking what it is – convinced me. That plus the title of the episode, and the previews that talked about the patient's inability to feel pain. Still.
Before smacking her with his cane, House also picks up on her Jewish name, pointing out that Ashkenazi Jews are at higher risk for the disorder, and makes some really lame Jewish jokes at her expense. Almost as lame as the black jokes he usually directs at Foreman. House's barbs seem to sting only when he actually means them.
When Hannah refuses to submit to tests, House and Hannah get into the Battle of the Handicaps Part II, following last week's match between House and the researcher in the wheelchair. Hannah can't cry. "Neither can I," House sneers. She has to check her eyes every morning for corneal scratches. He has to check his for jaundice from the Vicodin shutting down his liver. She can't run without checking her joints for swelling. He can't run. She can't be held by a boy for too long without overheating. He can't be held by a girl for too long because he only pays them for an hour.
Already, with the acknowledgment of his Vicodin habit's long term side effects, and the running prostitution joke-that's-not-just-a-joke-after-"Distractions," and Cuddy dating someone she met online after all House's jokes-that-weren't-jokes about that, and Foreman's once-seen girlfriend making a reappearance, and the reference to House's fellows being in a program (albeit one that probably should have an end point really soon, if not already past), "Insensitive" makes enough connections to the past to feel like it actually fits into a series. Yet it has a nice twist so it doesn't just feel like a comfortable old shoe: the cool diagnosis came at the beginning of the episode.
Sure, we still have the medical mystery of what made Hannah spike a fever after House manages to trick her into getting drugged, but the fascinating exploration of what it means to not feel pain – how far from a blessing it is – adds something new to this show that centres around a character who embodies what it means to be in constant pain.
When the fever indicates there is something wrong with Hannah apart from her extremely rare congenital condition, House orders a spinal nerve biopsy, among other tests. His team balks at the prospect of risking paralysis to diagnose a fever, so House quickly gives up trying to convince them and goes to Cuddy for approval.
The quickness and the going-to-Cuddyness obviously means he's up to something. As fast as he'd diagnosed Hannah's CIPA, he had diagnosed Cuddy's appearance on this snowstormy day as meaning she was going on a blind date. He tracks her down at the coffee shop she'd chosen for prime fleeing convenience ("low expectations work in my favour" says her charming date) to get his biopsy approval. He also gets the added bonus of humiliating Cuddy, though he seems disconcerted to discover her date is not only respectable, but not cowed by House.
While Cuddy is agreeing to the biopsy and hiding behind her menu in embarrassment, House's team is debating how to circumvent the order to get the dangerous spinal nerve biopsy. Foreman, Cameron, and Chase all prove in this episode that they've got some disturbingly similar traits as their bastard boss, and in this discussion, Chase seems just as cleverly heartless. He proposes torturing Hannah to cause enough pain to break through her insensitivity in order to track down where her injury is. Though, as he explains, it would be torture on anyone else, but for Hannah, it's like pricking a finger, and it beats risking paralysis.
However, watching a spinal nerve biopsy would have by far beat watching what they put Hannah through. This is not the best episode for the squeamish. Chase gives her second degree burns. Foreman drills holes in her head until she tricks him and escapes, only to threaten to jump off the balcony in a fit of paranoia, and actually do it when her legs become paralyzed. Hannah goes splat. She can't feel anything, but I felt my stomach turn.
Wilson, who wants nothing more than to gossip about the 11-fingered doctor and his new tranny nurse girlfriend, is exasperated with House because instead he finds he has to be his "damn conscience" again. Wilson and Cameron and everyone who's not distracted by their charming date thinks House is studying Hannah for his own curiosity. "Your focus is going to be on getting your answers, not hers," Wilson chides.
Undeterred, House picks up on the paralysis and nuttiness as two additional reasons to think nerve issues are the root of her current problems, and demands the spinal nerve biopsy again. His hopes are dashed when Cameron suggests thyroid storm, which he has to grudgingly admit is a likely candidate. The silver lining is that he should really consult with an endocrinologist to confirm the diagnosis, and who should be an endocrinologist but Cuddy. She may not be the endocrinologist on call, and he may not have really had to go all the way to her house to get the consult, but again, there's the added bonus of humiliating her.
For as he cannily intuits, she is still on her date when he knocks on her door. "You just met him," he protests. "I like him. And I like sex. Do I need to stitch a letter on my tops?" she asks playfully.
After eliminating thyroid storm as a possible diagnosis, she then does a little diagnosing of her own on House: "Do you like me, House?" she asks, stepping towards him. Since he usually avoids her instead of wanting her to approve his every move, she claims his actions could only be explained as an altruistic person worried about her well-being, or as someone who wants her for himself. He suggests the third option – the option that would seem the most likely except for his adorably disconcerted expression – that it could also be explained as an "evil bastard who just wants to mess with other people's happiness."
Whether it's door number two or three, House succeeds in messing with Cuddy's date. He heard the spark between Cuddy and House and wishes he could be dating that woman. Now it's Cuddy's turn to be disconcerted, since she can't seem to argue against the charge that she thrives on the challenge of House.
House is back to browbeating his team into getting a spinal nerve biopsy until he notices that Wilson has taken some of his papers, and Wilson seems to uncharacteristically pull a House by asking House's team if he's asking for a spinal nerve biopsy. How'd he know? Because the papers he stole indicate the possibility of growing nerves out of a spinal nerve – pain free nerves, if done with a CIPA patient's spinal nerve. House isn't just studying Hannah, he's hoping to harvest her nerves for his own gain. And his jealousy takes on a whole new spin. She literally has something he covets.
House is usually the bastard willing to risk everything – his medical license, his desire for a semblance of a normal life - to help his patients. But now he is the bastard willing to risk paralysis for Hannah in order to help himself. He's willing to forgo his ethics and risk a shorter life span to be free from pain.
Except Wilson actually succeeds in being his conscience by asking House to examine whether he's the right person to decide whether the spinal nerve biopsy is necessary. House does the right thing and leaves it to his team. They choose a nerve further from the spine that gets them the information they need – Hannah's symptoms are being caused by something systemic, not a neurological condition.
As Cameron and Foreman discover that in the lab, they have a happy Valentine's Day discussion about true love and commitment, with shades of their mutual affection post-"Euphoria," and shades of their tension, pre-"Euphoria." Cameron doesn't realize that House has correctly diagnosed Foreman as trying to avoid commitment on his path to a lonely life of success, and envies his relationship with Wendy, the pediatric nurse we saw once, way back when, in happier times.
Foreman points out that Cameron could have a social life (translation: sex) any time she wanted. She says she had "the real thing" once and isn't willing to settle, prompting Foreman the Tactful to express some skepticism. She presses him into confessing that while he doesn't know what she had, the sacrifices she made for her dying husband were at the height of her love for him. "I wasn't criticizing you," he explains gently, seeing how hurt she is. "People who avoid commitment are people who know what a big thing it is." Foreman, however, is not quite the Mr. Sensitive he thinks he is, considering the girl who's avoided commitment is also in love with a man who avoids commitment even more.
While the rest of the team debate what Hannah's systemic illness could be, Cameron takes off – under House's protests – to reunite mother and daughter. While giving her the satisfaction of seeing a human connection that doesn't involve her dysfunctional coworkers, it also gives the team the clue they need to solve the case: Hannah starts to cry and feel pain while fighting with her mother over who's sorriest about the accident. House adds "guilt" to the white board of symptoms.
It's natural that in House's world of rationality, an emotion would be a symptom, and apparently guilt is a sign of vitamin B-12 deficiency. That diagnosis would be easily curable by, strangely enough, providing vitamin B-12. But guilt is also a sign of sadness, which wouldn't be so helpful to the white board. House's cool theory is blown when it turns out Hannah had already been given B-12 when she was first admitted, leading to the conclusion that Hannah is, in fact, just sad.
Back to the drawing board. House brings even juicier hospital gossip to Wilson as well as Hannah's file, looking for a consult on leukemia as a more prosaic diagnosis. While stealing Wilson's sandwich, House has a food-related epiphany and takes off to rethink his B-12 theory. As he tells his startled team, "Someone else ate it." This is how dumb I am: I'm thinking "Her mom? Really? Why?"
But no, House wheels Hannah into an already occupied operating room and proves his versatility as a doctor by performing the surgery himself. Look ma, no mask AND no anaesthetic. The other surgical team looks on in horror as Hannah screams and protests in another paranoid fit.
The cool diagnosis came at the beginning of the episode, and the gross one comes at the end. House starts to pull out a 25 foot tapeworm from her gut, as those looks of horror turn into disgust evident even on faces hidden behind surgical masks, and one woman whips out her cell phone to catch it on camera.
With her B-12 stealing friend gone, Hannah's going to be just fine. Her mom is going to be pretty much fine, making the running comments about "oh no, what are we going to tell Hannah" a little anticlimactic, but giving us the happy reunion scene at the end.
Foreman and Wendy break up after he gives her the most romantic Valentine's Day present ever – the gift of moving away from him – and ridiculing her for not being rational in their break up fight. "Only you'd expect an argument to be rational. You and that ass boss of yours," she says cuttingly.
So Foreman is newly alone, by design, and we see Cuddy in bed alone, very much not by design, and Wilson and House together again. House is looking wistfully at Hannah and her pain-free spinal nerves, so Wilson encourages him to ask her to donate one. "If you want to do it, do it while her B-12 is still low. Guilt can be your friend." House has snapped back to the oddly ethical unethical bastard he is, though, and doesn't even consider it.
In a closing scene that's as funny as it is credibility stretching, Cameron proposes an arrangement to Chase: sex with no complications. She's picked him because he's the coworker she's least likely to fall in love with. Poor Chase. Wait, what am I saying? Sex with no strings: lucky Chase. Except Cameron is apparently too busy with the doctoring to have ever seen a sitcom before, so I know what she doesn't: there's always complications. At least she's not paying the guy by the hour.
FOX is being insensitive to my House needs and withholding the show for the next couple of weeks. It returns in three weeks.