TV Review: House, MD – “Merry Little Christmas”

Throughout its three-plus year run, House, MD has featured numerous heart-wrenching scenes. Scenes involving the patient alone and House alone, and scenes involving House and the patient together. Of these poignant moments, "Merry Little Christmas", a mid-season three episode re-run Tuesday evening on FOX, features several. But a scene towards the end of this episode, during which House leaves his mother an emotional "Merry Christmas" message is surely the most heartbreaking scene in the entire series to this point. It is a moment that never (no matter how many times I’ve seen it) fails to leave a lump in my throat.

This week’s patient is a teenage girl with presumed dwarfism (presumed because of her short stature and her mother’s own dwarfism). She exhibits symptoms that suggest any number of disorders. In the midst of this diagnostic dilemma, Wilson has made a deal with Detective Tritter to drop the drug charges against House if he agrees to enter drug rehab — a deal that House, of course, refuses. Wilson convinces Cuddy to deny House his pain meds and revoke his hospital privileges in an attempt to manipulate him into taking the deal. Still refusing, and betting that he’ll be able to cope without drugs longer than they’ll be able to cope without his skills, House retreats to the solitude of his flat.

The team, along with Wilson and Cuddy, attempt to diagnose the perplexing young patient without the benefit of House’s wisdom and experience. Unsuccessful, first Cuddy and then Cameron visit the oracle of House, appealing to his better nature. He initially resists his natural urge to help with the case, flatly refusing to help unless Cuddy relents and lets him have his meds. Eventually, however, House does come back into the case, Cameron convincing him that Cuddy was not going to give in, and appealing to House’s strong sense of right and wrong. (He could not allow the girl to die to simply prove a point.) Even strung out and in agonizing pain, House, alone, is able to see the connections in the case that no one else can.

This is not lost on Wilson, who, perhaps for the first time, acknowledges that what House does is not a “flip of the card,” or simple luck. House has a singular gift. It’s an epiphany that moves him to go back to Tritter, willing to sacrifice himself for the uniquely talented House. It’s a noble, but fruitless gesture, and one which not only fails to undo the damage done to House, but puts Wilson at risk as well.

Although House’s initial diagnosis is incorrect, he does ultimately solve the case. As it turns out, Abigail is not a dwarf like her mother. She has a condition that has left her short of stature, masking a neurological symptom, which, now revealed, enables House to solve the case. And with appropriate treatment she can grow to a normal height. As House bluntly puts it, the treatment is her “ticket out of the freak show;” a freak show of which House considers himself a part.

When the daughter (encouraged by mom) refuses the treatment, preferring to retain her uniqueness — the differentness that her physical condition grants her, House empathizes — and respects their point of view. But he disagrees. He asks the mom if she really wants her daughter to have to constantly have to always be tough just to survive. “Being a freak makes us strong,” he acknowledges. “But how strong do you really want her to have to be?” House's impassioned plea to the mother changes her mind, and she tells Abigail that she should take advantage of this opportunity to have a "normal" life.

Sick from the forced withdrawal and nearly out of his mind with pain, (even going so far as to deliberately cut himself for the endorphin rush) House has been downing pill after pill of the powerful pain killer. And when Wilson finds him alone in his darkened office on Christmas Eve, case solved, he is clearly worried about House’s state of mind, and doesn’t want him to be alone. But House dismisses his offer of companionship with an oh-so-bitter laugh, leaving a worried and stunned Wilson standing alone in House's darkened office.

So House returns to his flat, alone, knowing that the time clock on Tritter’s deal is about to expire. It’s a somber moment, as if the entire series of events since his shooting has finally come crashing down around him. He sees a bleak future, his vision certainly clouded by the drugs, the pressure, the whiskey, and the relentless pounding his life has taken since having been shot. He is sentenced to a life of relentless pain, constantly having to justify its validity — even to his best friends, and has to wonder if it’s all worthwhile.

And then comes that breathtaking scene where House calls home. Knowing that his mom is attending a family Christmas party, he speaks — haltingly, wistfully, heartbreakingly — into the phone, leaving a voice mail message that is as much “goodbye” as it is “merry Christmas.” Wilson finds him hours later, delirious, collapsed on the floor. Disgusted with his friend after noticing the name of his patient on the Oxy bottle, Wilson leaves House on the floor where he finds him.

Gregory House is generally a very strong man. He has suffered adversity (which we now know includes an abusive father), suffers severe chronic pain, and bears the burden of genius that not even his closest associates really understand. Ascribing his ability to discern subtle connections to “luck” and “guesses,” even his best friend fails to acknowledge (until its nearly too late) that what House does is no parlor trick.

Despite the anguish he’s in, despite the fact that he’s high on the Oxy; that he hasn’t slept in days, and is physically and emotionally at the end of his rope, he retains a stunning clarity and empathy that allows him to not only diagnose Abigail, but to convince her mother to go along with the treatment. But even a strong man breaks when pushed hard enough.

Normally, House’s default position when he’s pushed is to push back, but harder. But in “Merry Little Christmas,” House’s inner reserves of strength are nearly sapped. And when he asks the patient’s mother “How strong do you really want her to have to be?” he could have just as easily been referring to himself.

Hugh Laurie flawlessly conveys a man at the end of his emotional rope, in what may be  some of the finest acting I have ever seen — particularly in the phone call scene. There is nothing overt or over the top. The quiet desperation in House’s expression; the stillness; that tearful message. Hanging up the phone quickly, before allowing himself to say anything else or lose his resolve. Glancing at the nearly empty pill bottle (which only hours before contained 30 pills.) The silent determination to take the remaining pills and chasing it with the whiskey; forcing himself to drink the entire contents of the tumbler. It’s a quietly devastating scene. And it’s all in the performance, in the virtually dialogue-free scene. And it’s a brilliant performance.

As the episode closes, House, having gathered himself together, raises the white flag. But it’s too late. The deal (if there even was really a deal — we don’t know if Tritter wasn’t lying to Wilson to get him to betray House) is off. So ends House’s “Merry Little Christmas.”

A year later, we all know how it comes out in the end. But that knowledge in no way lessens the punch to the gut that this episode delivers.