TV Review: House, M.D. – “Twenty Vicodin”

There’s been a lot of reaction on the Internet the past couple of weeks about House, M.D. creator David Shore’s insistence that “people don’t change.” When Shore talks about House (Hugh Laurie) being unable to change, I think he means change fundamentally who he is. We are who we are, and no matter what (or whom) else House tries to re-invent himself to be, he will revert to himself.

House is a jerk; he will always be that no matter how hard he tries to conform. He can control its intensity and his behavior, but ultimately, he is who he is. House has a pessimistic worldview. He may enjoy moments of enjoyment—even happiness. He may dip his toe in the water of love and domesticity. But House’s view of the world was formed when he was young, perhaps predestined when he was an infant with a mother who felt guilt for his very existence and a father who never loved him. House is a healer; he can’t help himself. And as much as he proclaims that he is out of medicine for good in the season eight premiere “Twenty Vicodin,” he can’t help being himself. Elemental change is not possible.

Can House adapt? Can latent or suppressed personality traits emerge in new circumstances? Can he adjust their behavior in a more (or less) successful attempt to become a “better” person or at least conform to others’ expectations? Can he become more—or less—guarded due to things that happen to him? Of course he can, Dr. Gregory House has done all of those things. But in the end, we he is who he is.

“Twenty Vicodin” opens with House in a New Jersey State Prison sitting before a parole board. They are willing to grant him early release if only to save the continued costs of a prisoner who’d already been in jail for months and had exhibited “good-ish” behavior.

The only problem House has, is that he must stay out of trouble for the five days until his release. Even House has trouble believing that it’s possible. Staying out of trouble is not an easy feat for House under the best of conditions, but these will be five very difficult days for him.

The inmates are bullied by a protection racket led by a particularly brutal, small man with fascist leanings. We learn that House has already been giving up half his Vicodin dosage to these guys, but it’s about to get more difficult for him as the gang elicits an “exit tax” on all inmates about to be released. House’s tax is 20 Vicodin, his entire week’s allotment.

So how had House managed to get hard time when, as prison doctor Jessica Adams (Odette Annable) observes, House has had no prior convictions—and no one had been physically injured by his actions. We learn that House hadn’t hired a defense lawyer, instead taking the first deal offered in exchange for a guilty plea. He’d apparently put up no fight, and as Adams suggests, perhaps House intentionally subjected himself to a much harsher sentence than he was due (or would have gotten with a lawyer).

It doesn’t surprise me that House would punish himself much more harshly than would the legal system. He is usually his own harshest judge. And despite his characteristically defiant sarcasm to the parole board, House carries a lot of guilt on his shoulders (not undeserved, in this case) for a great many things. How many times, I wonder, during his time there has House provoked a prisoner to beat him?

The events of season seven have taught House that something has to change in his life. So, House has decided that he wants nothing more to do with medicine. Although, as young prison Dr. Adams observes, House has a “gift,” House believes that it is his gift that’s gotten him into so much trouble. Explaining that he intends to pursue a PhD in particle physics, House says that he wants to research dark matter: the biggest mystery in the universe.

Physics (at least I think they’re physics) equations line the white wall around his bed and the overhang from the bunk above him. It’s as if he’s had a bad breakup with medicine (and the humanity medicine forces him to be around) and has hurtled himself into another discipline. Likely feeling the full impact of his actions, House may believe that only by divorcing himself from humanity entirely—holing himself up in a physics lab may be the only way for him to move on.

As he explains, when he gets out of prison, everything’s changed. “No medicine, no fixing people—done!” He seems to believe that there’s no longer a place for him among “normal people.” He’s so far outside “the circle,” he can’t get anywhere near it. He observes, “There’s a reason we’re locked away from nice normal people.”

For all his personality flaws, House is a natural, and even charismatic, leader when he wants to be. House has been accustomed to being a rock star of medicine for years, getting his own way; making his own rules. But in prison, House has lost all power. His job is to follow the rules; not make up his own.

He is way down on the prison food chain, and although his intelligence has probably allowed him to survive during his time there, he’s nowhere close to top of the pyramid. Physically, he’s at a great disadvantage—always, and in prison, he’s pretty much at the mercy of the prison gang to whom he’s paid “protection” (half his Vicodin dosage). He fears his psychotic cellmate enough to monitor his meds and go way above and beyond to be nice to him. (Even curing a sick pet cricket.)

The House we see through most of the episode is beaten down; strangely passive. He doesn’t want to tick off either the official Powers That Be or the prison gang. He’s vulnerable, out of his element and, for the most part, just trying to get along and get out. Although he’s still manipulative, his game playing seems simply a survival tactic.

House is slowly drawn into the mysterious symptoms when a fellow inmate starts exhibiting unusual symptoms. In a way, diagnosing the case becomes his reality check. It reminds him of who he is; who he needs to be, human contact—or not. But it also seems to re-energize him. And in the end, House is House—a doctor and a healer—and someone for whom “being right” and doing the right thing are elemental forces within him.

Witnessing a perceived injustice against the sick prisoner, House finally becomes House. It’s like he puts on his superhero “House the Healer” medical white coat. At that point, he could care less about parole, retribution, or anything else. He needs to be right; needs to do the right thing—and needs the prison doctor to the right thing, when he no longer can. Refusing to put up with a bureaucratic doctor who won’t break protocol to administer five aspirin to a patient, even if it means saving a life, House risks his freedom (like he’s risked his life and his career so often) to save a patient. This is the essence of House; who he is. And despite the fact it costs him his parole, House can’t help but smile (for the first time in the episode) when he learns that he was right—and the patient has been saved. It was the right thing to do; the only thing House could have done.

I really liked “Twenty Vicodin,” and the more I’ve thought about it, the better I’ve liked it. It’s a great character study of House in a truly foreign environment. Yes, it plays like a transitional episode—a stand-alone like the season six premiere “Broken”—and it is hard to know exactly where the series is headed this season until House gets back to his more familiar territory next week when he returns to Princeton-Plainsboro. The episode also works as a vehicle to give us insight into House’s state of mind a year after the crash. I got a strong sense of where House is emotionally; and his feelings about what happened in “Moving On.” But we only get this sense very indirectly—how he acts; how he reacts to this environment and its people, and what he says when he’s not in full-on confrontation mode.

The twenty Vicodin subplot frames House’s state of mind during the five days we follow him. But it also parallels the episode’s main plot and the dynamic between House and the medical case.

The only thing in “Twenty Vicodin” that didn’t ring quite true to me was the bit of exposition House provides about the crash. To me it sounded like a bit of backtracking and rationalization—not so much on House’s part, but by the series—in reaction to the storm of controversy (and negativity) about the season seven finale’s ending.

“I knew the room was empty; I knew Rachel wasn’t there” to me sound like explanations not only to the parole board, but to the viewers. And maybe it’s because all summer I was hyper-aware of the negativity (more so since I didn’t agree with it), the scene seems, to me a bit artificial and tacked on for the fans’ benefit.

So, on to next week and “Transplant.” When House gets out of prison in next week’s episode, he will have to adapt big time. Little in the world he has known for years will be the same. I am looking forward to following House as he struggles with his new circumstances, the new dynamics at the hospital, and with his guilt.

As much as I enjoyed “Huddy” and as much as I enjoyed Lisa Edelstein, her departure opens up a world of new possibilities for the show. I look forward to the rest of season eight, so bring it on!