TV Review: House, MD – “Cane and Able” (Revisited)

With FOX re-airing House’s third season on Friday nights, this week we got another peek at “Cane and Able,” episode two. I can’t honesty tell you how many times I’ve watched this emotional episode. (Trust me, it’s a lot.) But each time I pick up more nuances to Hugh Laurie’s perfect performance that cause my heart to break for House.

I think it is clear by the beginning of the third season that House’s best friend Wilson has a fundamental misunderstanding of House and how his genius works. Wilson may understand his friend on a personal level, enabling him to tolerate House’s less virtuous character traits, and I think Wilson cares about him (and vice versa). But I think that Wilson’s lack of understanding about House’s intellectual life and his psychology nearly destroys House. And it is not until “Merry Little Christmas” that Wilson begins to understand, when it is nearly too late. (Ah, but what good drama that makes!)

House is, in a lot of ways, like a math genius who always knows the answer, but can't quite tell you how he got there. His epiphany about Richard (the wheel-chair bound patient in “Meaning”) at the university pond was not unlike associative leaps he's made a hundred times in the past.

But this time, House’s stroke of diagnostic genius occurred in a context of which Cuddy and Wilson could not make sense. Wilson and Cuddy were chagrined that House had somehow twisted his own intention to simply “help” Richard into a diagnostics case because he couldn’t resist “playing God.” Because he needed the “fix” of a puzzle, the “rush” of solving a medical mystery. The fact that House was actually right made little difference, whatever House’s motives. But that was last week. And now, Richard, cured based on House’s theory, is back at the hospital, well on the road to recovery.

Richard, however, is the least of House’s problems. The twinge of pain that House felt in “Meaning” has returned with a vengeance. Early in the episode, House is thwarted by obvious pain preparing to go for a run. He spots his cane, sitting idly in an old golf bag; it seems almost to taunt him, and House clearly is tormented by the reminder that he stands on a precipice, and it can all come crashing down. And soon. House reluctantly takes a Vicodin and shakily makes his way to the shower. No run today. Another in a long line of signature Hugh Laurie dialogue-free scenes, providing us with more insight into House’s inner life than would 20 pages of dialogue.

Noting that House is limping again, self-appointed House-sitters Wilson and Cuddy warn him not to slack off on the rehab. Clearly not something he wants to discuss, House deflects, leaving Wilson and Cuddy to argue about the cause of the returning pain. Has House lost his confidence, causing him to become withdrawn? Or it is simply (and tragically) that the ketamine is failing? In any event, Wilson sees House’s recovery as an opportunity to steer House towards a simpler, less risky form of medical practice, rendering him less reckless, and perhaps less self-destructive? Wilson continues to operate on the false assumption that House’s associative leaps and intuitive flashes are simply “luck,” risky for the hospital, for House, and for patients.

House’s team also notices the decline in House’s physical condition. When House falters mid-sentence, his leg suddenly giving out, House retreats to his default position. "I tripped," he deflects, covering badly.

House diverts focus from himself by jumping into the diagnosis of the young patient, a boy whose dreams seem to have been pulled straight from the X-Files archive. (Not surprising, since this episode was directed by Daniel Sackheim, a veteran X-Files director/producer). Ignoring the more exotic symptoms, House pursues the simpler diagnostic path provided by the kid’s rectal bleeding. Ordering routine testing stuns the team, especially Cameron, who goes off to clinic duty.

Astonished to encounter Richard, now ambulatory and being treated for Addison’s disease (which House had diagnosed), Cameron discovers Wilson and Cuddy’s deception. As Cuddy argues that they’re only trying to teach House a little humility, Cameron rightly maintains that House isn't like "everyone else". He is unique. He needn't be taught a lesson. She reveals that House’s “failure” with Richard has affected him; put him off-kilter in the aftermath of all that’s happened to him. “He’s dismissing symptoms; he’s in pain…” I liked Cameron here — protective of House, who she knows is a lot more fragile than he would ever reveal.

The first scene between House and Cuddy explores everything I love about their relationship. "What's up with the leg?” she asks simply, visiting House in his office. Ignoring the subject, House deflects, teasing her about her maternal aspirations. She allows the teasing, ignoring it, knowing that it’s a cover. "You're in denial," she prods, refusing to let it drop, as House would want.

Finally exposed, House drops the façade, granting her access. Their actual conversation is less important than the subtext, eloquently expressed via body language and glance. She pushes to do some tests; he lies, telling her that he’s got it under control. Finally he tells her that he’s fine; that if there was a problem with the leg, he’d do something about it. She knows that he’s lying, but she has no recourse but to accept his answer. Her teary eyes express her worry about him; that she knows it’s all going to hell for him — and there’s not a damn thing she can do about it. (Cuddy’s not quite convinced at this point that she should expose the deception.)

As House’s leg gives him more and more difficulty, he becomes increasingly distracted and more and more uncomfortable with the attention being cast upon him. He continues to falter with the diagnosis as his confidence vanishes along with the promise of a life without pain. Cameron warns Wilson and Cuddy that they had better figure out how to restore House’s confidence before it’s too late. (That she does so with an amusingly self-referential Blackadder quip is a delight.)

Wilson’s “plan” is to goad House. He thinks that House is deteriorating because pain is making him slack on his rehab. “I want you to run,” Wilson says, throwing a bottle of Vicodin at House, still believing that it’s simply the pangs of middle-aged muscle soreness holding House back from his exercise. But House knows better; the defeat in House’s voice is heartbreaking. But Wilson continues to push, telling House that he’s been wrong more often than right lately. Way to kick your best friend when he’s down, Wilson!

But Wilson’s cutting words serve their purpose, provoking House to the treadmill (and to one of the more difficult to watch scenes of the series). In the darkened physical therapy room, House tries to push himself past the pain, desperately running until he cries out in agony. Stumbling off the treadmill, House pops a Vicodin before going at it again. More than simply running, House is trying to hang onto something that’s slipping away and out of his control.

House has seemingly paid a high price for attempting the radical ketamine therapy. In his “No Reason” hallucination House is angered when Cuddy performs the treatment on him. He argues that the potential loss of his reasoning skills (a side effect of the procedure) is too high a price to pay for a pain-free life. But provoked by his own subconscious (represented by the shooter), House chooses “life” at a critical point after being shot; chooses to take the risk for the opportunity of a “normal” life.

Now, only three months later, not only has the effect of the ketamine begun to wear off, House’s diagnostic acuity also seems to have gone awry. House (erroneously) believes he has lost the one thing about himself that he values — and for nothing.

Resigned and broken, unable to diagnose the patient in his care, he tells the team that they’ve done their best and to send him home, still undiagnosed. They have fixed the boy’s bleeding problem, and that has to be enough. With so much of House’s self-esteem tied up in his reasoning ability, he is wrecked as he watches everything slip quietly away.
Cuddy catches House as he’s about to leave for the day, case unsolved. She implores him to continue diagnosing the boy; to do the things he always does: make the insane, but eventually correct, radical decisions that almost always (eventually) lead him to the answer. Just the sort of thing Cuddy shut him down for only week before. She even gives him the green light to perform even the most radical of procedures — no questions asked. Now House is really suspicious.

As Cuddy confesses the deception regarding Richard, House has an epiphany about the current case. As Foreman tell the young patient, now cured, that everything will go back to normal, House listens to the truth of what that means for his own life. For him, “normal” means unrelenting pain and dependence on a cane and narcotics. No more running; no more golf; no more skateboarding. It’s over.

Finally confronting Wilson about the deception, House accuses him of masterminding the plan. Wilson defends his actions, comparing House to Icarus, whose father warned him not to soar too close to the sun. "I was afraid your wings would melt," Wilson confesses to his friend. Far from thinking himself god-like, House bitterly counters, “God doesn’t limp.”

"What do I have?" House demands of Cuddy during his “No Reason” hallucination. In his brutal self-analysis, his genius is all House possesses of value. Nothing else. It, like the Vicodin he had been popping like candy for two seasons, allows him to get up in the morning and see himself through the day. It's his bread and water; his sustenance. Another betrayal in a lifetime of them has come dangerously close to stripping him of even that.

Finally home, House must confront the reality once again. His brief glimpse at the good life (as Wilson put it) is over—a failure, placing him back at square one. The agony of House’s disappointment pours out through his sad eyes as he reluctantly picks up his cane. You feel House's resignation and defeat…and his acceptance that for all of the risk, all of the work, he is back at square one.

New episodes return on Monday (new day for House) April 28. In the meantime, if you haven't already, enjoy my House Trivia Quiz. Answers will be posted early next week.