TV Review: House, M.D. – “House Divided”

“I haven’t slept through the night since Kutner died.” House’s  (the ever-amazing Hugh Laurie) grave admission to Cuddy (Lisa Edelstein) towards the end of “House Divided” tells us how worried House is about his own sanity. In that confession, the normally very guarded House finally articulates the depth to which he has been affected by Kutner’s death.

What a fantastic episode. The best House, M.D. episodes combine humor, drama, tension, and fun; darkness and light. This one had all of that and more — a pivotal episode in this very dark character arc for House (perhaps the darkest yet – and that’s saying something).

As this week’s wild ride of an episode, “House Divided,” progresses, Amber’s (Anne Dudek in a phenomenal performance) constant and increasingly aggressive presence becomes more and more difficult for House to cover, as all around him begin to wonder what’s wrong. Sleep deprived and exhausted, House knows she is simply a hallucination, his overworked and sleepless brain playing visual and auditory tricks on him. Taunting him, she asks why she is the one to plague him; why she has become the avatar for his subconscious mind.

With strong resonances to last season’s finale episodes “House’s Head” and “Wilson’s Heart,” Amber reveals what many of us have known all along. House carries with him an awful lot of guilt—the weight of the world, in some ways. Deny and deflect as he does and has, he still feels responsible for Amber, and more recently for Kutner. “Maybe your guilt over Kutner’s suicide reminds you of how guilty you felt about me,” she needles.

Refusing to engage with a figment of his imagination, House insists to her that she is “the product of my exhausted brain.” But whatever has brought her to House, she sticks to him like “white on rice.” But in an almost creepy progression, Amber morphs from simple annoyance to constant muse to something more sinister. By the episode’s end, House sees her for what she is — his worst inclinations unbound and at play in his conscious, troubled mind. “House Divided” indeed.

We often see House struggling alone in the dark of his office or apartment with his thoughts about a patient, an ethical decision — or even his own life. What are the thoughts that float through that “rat maze of a brain” (as Wilson has put it) that provide House his genius and his biggest problems? With Amber the external embodiment of House’s thoughts, we see how his thought process works. But he’s playing with fire. (So what else is new?)

Amber represents the far reaches — the “glimmers” and glimpses of memory. The fleeting stuff that whooshes by barely considered; barely acknowledged. Those thoughts are always there but expressed aloud, they have more prominence, and House has easier access. In his current state, Amber may represent a gift, not a curse or irritant. Properly channeled, maybe Amber’s insights can help restore House’s diagnostic superpowers, which he believes he’s losing (as he expressed last episode).

It’s a seductive idea, especially because House thinks he’s losing his medical mojo. No longer an annoyance, Amber has become his muse and his ally in solving the current case. Plenty of time to sleep after the patient is diagnosed. Never mind the sleeping pills Wilson has provided; Amber has given House a new lease on his mojo.

But why is she really there? Is she the manifestation of House’s guilt? People who watch the series carefully know that House’s refusal to acknowledge his indirect responsibility for Amber’s death is simply a “river in Egypt.”

Amber’s death hit House very hard, harder than he would have had his colleagues believe. And the subsequent loss of Wilson’s friendship, his father’s death, and Cuddy’s new baby all have taken their toll on House’s fragile psyche. I have always said that House’s problem is not that he feels nothing or too little, but that he feels too much. And he’s faced an awful lot in the past year.

And then Kutner’s suicide, seemingly random and with no note, no hint, no sign. That was the proverbial last straw. As Wilson told House in “Saviors,” it would be insane if he wasn’t a little out of whack. But House has been sleepless for weeks, haunted by Kutner, probably unable to turn off his mind as it processes every bit of information about him: his life, his work, his family, and his death. Long after everyone else has begun to move on, House cannot let go of it. Remember how long he held on to Esther’s death (“All In,” season two). House is not a “little” out of whack.

And so House acquires Amber as an increasingly dominant presence in his thoughts. But Amber loses her muse’s luster as she dominates House’s process. She becomes more and more real to him, as the story progresses. And as Amber becomes a more and more dominant element of House’s thought process, House begins to  accept Amber’s thoughts and ideas to the exclusion of all else — even his own conscious thought.

Has House really lost that much confidence in his own medical judgment, to the point where he must second-guess himself (literally)? Those little glimmers and flashes are in the back reaches of memory for a reason. They’re great to access in small bits: a memory there; an idea here. But as House retreats more and more into himself, he begins to conflate those flickers of ideas for something more substantial, although Amber holds the key to some correct diagnostic turns and some that are very wrong. House loses his ability to distinguish between them, relying on Amber rather than his conscious and filtered thought processes.

Eventually even House’s team fades into a surreal vision, seeming far less tangible than Amber, as House retreats further and becomes more isolated from reality. House’s mind wanders through memories of medical school (which may be helpful to the diagnosis) to strippers, as Amber helps him remember the stripper used at one of Wilson’s bachelor parties as he prepares to hold one for Chase.

When House’s Amber-inspired diagnosis turns out to be wrong — and he forgets that Chase is allergic to strawberries — House begins to realize that his insomnia-induced hallucination may not be the gift it appears to be. When called back into the unfinished case, House tells Cuddy that he can’t do it, no longer trusting either his instincts or his skills. Locking himself away in his apartment,  where he can do no more damage to the patient, he turns the case over to his team. Despite Amber’s urging, House begins to understand the terrible trouble he’s in. And that Amber must go.

Finally going to Cuddy to get a new prescription for sleep meds, Cuddy asks him what’s wrong. “Talk to me,” she pleads. Seeing Amber standing there as real as Cuddy, and looking deep into his own heart, the seriously freaked-out House is able to admit to not having slept since Kutner died. But not even a good night’s sleep can rid House of his hallucination.

Impaired as he is, House treats Seth, a deaf 14-year-old wrestler. Suddenly when in a meet, he “hears” explosions. Exploding head syndrome in kid who lost his hearing at the age of four. Wondering why he hasn’t had cochlear implants, which would allow him to regain his hearing, House learns that Seth is unwilling to leave the comfort of the disability and culture to which he’s adapted. His mother is his prime enabler.

House has had such dilemma with patients before, where questions of quality of life lead House to propose dangerous procedures or to mock family members who would prevent him from taking a risk that could bring the patient back to “normal.” “Merry Little Christmas,” “Half-Wit” and this season’s “Painless,” (although that patient simply wants to die) all get to that very sensitive spot in House.

House can never understand why people would choose to be disabled when they can be normal. He can’t process why anyone could be comfortable in their disability to the point that they refuse to undergo even a simple procedure to become “normal.” House convinces Chase to insert cochlear implants without the family’s consent. He, with Amber’s urging, is convinced that once the kid has the implants, he’ll adjust and be fine with it; as will the mom.

But how different is Seth than House? Is House too comfortable, wearing his disability (and the drug use) like a badge, afraid to try to “fit”? Does he need someone to push him off the edge to get him to save himself? Yes, House has tried (and has been at least halfheartedly trying) all sorts of things to end his pain. But he’ll try (like the methadone) and stop when the risk of losing his gift becomes too great for him to continue to risk it. But is Amber’s real role to be a genuine scare in House’s life? A dramatic enough scare to cause him to change?

The only thing House values in himself is his intellect and his medical gift. If he can’t trust his own skills (as he could not by the end of the episode) what does he have left? What would be the one thing to drive House to seek help? It would be the loss of his skill — or the loss of his rational thought. I don’t think he’s at that point yet, but there are still two episodes to go.

Lightening up the very dark journey into House’s subconscious is the planning of Chase’s bachelor party. House planning the Caligula-esque fete is hysterically funny — he’s like a kid in a candy store. Sending Foreman and 13 out to scout strippers is an inspired move, and the fiery  cocktails are pretty amazing, not to mention the alcohol drenched ice cream. Inspired. That Gregory House sure can plan a party when he wants to. And kidnapping Chase: priceless. Is he just into parties, or is he doing something nice for Chase? Is he trying to ruin Chase’s happiness with Cameron, or simply wishing Chase well in the best “guy” way he can?

It’s not the party, but the planning that seems to make House happy. House has never really shown himself to be a party person (although he talks a good game).

Having seen a couple of the party clips before the episode aired, I could not quite understand how House, the reclusive, guarded, private man he is, could be partying like that. Turns out that he didn’t. He set it up, he got it going and then distances himself completely. Very, very House-like.

I am growing to like “Foreteen.” I loved the fact that Foreman paid money to see 13 have fun with the stripper. And Wilson? What a cheap drunk he is, isn’t he? Chase was adorable, and Cameron was resigned by willing to go along with the whole thing — sort of.

But the party, a delirious, dizzy affair, turns dark when Chase licks the strawberry butter from the stripper’s stomach and goes into anaphylactic shock. House blames himself, cursing his subconscious (in the guise of Amber) for possibly killing Chase. Obviously, either House forgot or didn’t know, or was too tired to remember. Hit hard with the notion that he could have caused another death of someone close to him. More guilt. “I knew about the body butter; I knew about Chase’s allergy. I tried to kill Chase. Why would I do that?” That one line, House taking the blame on himself for Chase’s allergic reaction is almost the scariest moment of the evening. What would make him take on yet more guilt? Undeserved guilt.

And then this week’s sucker punch. House, looking much better after a good night’s sleep and not seeing Amber, is also feeling better thinking he’s rid of her. Until there she is. Right with him. Major freak-out for House. Whew!

And next week — all I can say is take the “Huddy” poll (if you haven’t already). More than 1100 people have already voted. “Under My Skin” airs Monday night at 8:00 p.m. (ET) and the season finale, “Both Sides Now,” will air on May 11. Just as a note, I will be interviewing “Both Sides Now” writer (and House co-executive producer) Doris Egan the day after the finale airs.