First, my apologies on getting this review up so late in the week. I wanted to mull it over, given the episode’s dual themes of pain and suicide, two themes that have threaded through four and a half years of House, MD. So forgive me if this reads more like a short essay than an episode review (author’s prerogative, I suppose).
Of course House’s own pain is a major trope of the series: its ebbs and flows affecting (or even being affected by) House’s emotional well-being. Throughout the four-and-a-half years of House, MD, we’ve witnessed House have better days and worse days. And occasionally, really bad days. He seems to have hit another bad patch now, which is not too surprising considering the stresses he’s been under since the end of last season. Emotional stress absolutely seems to make House’s leg pain worse.
Usually House conceals his pain, hiding it beneath a biting sarcasm; deflecting with an insult before anyone (hopefully) notices. He steadfastly refuses to allow himself to be defined by his disability to the point where denial of its power defines him anyway.
But as we see in “Painless,” when he is alone, House suffers much more than he lets on. Sitting in the bathtub (presumably to soak his leg), House appears to be in terrible pain, barely keeping it together. I have to say that Hugh Laurie does such a brilliant job of portraying House’s pain that to watch it, I feel almost a voyeur. His eyes, the hunch of his shoulders, the heaviness with which he leans on his cane or walks without it tells us whether House’s pain is a “10” or merely a “5,” which, for him, might be a “good day.” As he told detective Michael Tritter in “Words and Deeds,” his pain is “merely intolerable” on good days, but “soul-sucking” on bad ones.
Although it’s not quite as pervasive a House theme as “pain,” suicide has been tackled several times during the series run — in different contexts. “I got no problem with people killing themselves,” he tells his patient in “DNR.” And he doesn’t – after the patient has all of the relevant information. After that, it’s the patient’s call. In “Painless,” when Jeff attempts suicide a second time, House seems almost angry that Jeff is determined to kill himself, refusing to allow him the privilege. “Just let me die,” pleads Jeff. “No,” is House’s emphatic response, not while there’s a chance he can be cured. That has been House’s M.O. In "Informed Consent," Wilson advocates that House help Ezra Powell die, reminding him that he's assisted a patient's death in the past. House counters that he's only done that when the patient is terminal, "and we're nowhere near that," he emphatically insists.
House has never seen suicide as being a relevant way to “go onto something better.” He doesn’t believe in that “something better,” only the here and now. With no belief in an afterlife or heaven, House strongly believes that a miserable life is better than no life.
Is he opposed to suicide? No. And he has facilitated it — and understands it. (Gabe in “Son of Coma Guy” and “Informed Consent” — after the “terminal” diagnosis made a painful death inevitable. Even for himself, he surely had to have at least contemplated it in “Merry Little Christmas.”) However, as miserable as he is, when it would have been easier for him to simply give up, the tenacious House has fought himself back from the brink three times since we have known him (“Three Stories,” “No Reason,” “Wilson’s Heart”). Perhaps it’s part of his personality, never allowing himself to let go – to give up – but fundamentally House has consistently believed that a miserable existence (since everyone’s miserable) is better than the nothingness that is at the end of life. And while hope exists, suicide is not something he advocates.
Back in season two, House had a couple of episodes when his pain meds stopped working (“Skin Deep” and “Who’s Your Daddy”). Between those episodes, we witnessed House having more and more difficulty walking and clearly in a greater amount of pain. Despite the placebo effect of the saline injected by Cuddy in "Skin Deep," by the episode’s end, it had worn off, and House continued deteriorating until the end of the season when he was shot. But clearly during that time, his future was weighing heavily on his mind. Resorting to morphine use, and an bleak future, House is shot by a former patient in the season two finale, but as he lay bleeding to death, his survival uncertain, House chooses “life,” when death would have been so more simple an answer for him. Instead of letting go of it all, he fights back to consciousness long enough to request an experimental pain treatment. There is something about House, that despite his depression, his disability, and his pessimistic outlook on humanity that keeps him coming back. Whether it’s courage or a deeply-buried, underlying optimism, he cannot give up on life. It’s like he told Apple in “Not Cancer” when she senses the similarities between them. “Only difference is, I haven’t given up,” he tells her — a patient who has given up on finding any sort of joy in her life.