“Top Secret” answered the question House fans have been dying to know since the series premiere over 2 ½ years ago: Just how much urine can one episode contain? The answer: A lot.
In this episode, we – and he – are seeing that the negative consequences of House's Vicodin dependence are not just social and psychological, but physical too. In a series of lovely bathroom scenes and shots of Hugh Laurie's grimace when confronted by sloshing liquids, we see House's torture resulting from the fact that he hasn't been able to urinate for three days, likely a side effect of his pain medication. Yet he holds onto the Vicodin like a baby with its blankie – no other will do.
Cameron asks about his pain, Wilson futilely tries to convince him to stop taking fistfuls of Vicodin in order to relieve the pain that the Vicodin is causing, but House appears to have burned up a lot of the energy anyone's willing to devote to sympathizing much. Faking rehab and brain cancer does that, I guess.
But back to the beginning. The teaser shows a Hummer full of soldiers singing and joking before an ambush we get in full shaky cam glory. Because I am generally clueless about anything to do with the visuals of a show, I’ve gotten pretty proud of my ability to spot the work of frequent House director Deran Serafian before the credits roll.
The usual pre-credits bait and switch applies. Not only are we not seeing the injury of this week’s patient of the week, not only are we not being set up for House's take on the war in Iraq, but we’re not even in the show’s reality. Throughout, the camera has been following the point of view of one of the soldiers, one who was being treated by his Hummer-mate, when it pans away to reveal the injured soldier is a fatigues-clad House, gun in hand and leg blown off. Yes, that leg. That's gotta hurt.
He wakes up to Cuddy tossing him a file of his new patient, and he’s stunned to see that the picture in the file matches the face of the soldier who saved his life in the dream. Spooky.
The rest of the episode serves as both a medical mystery, as House tries to prove that his Gulf War Syndrome is actually nothingswrongitosis and then to discover what the somethingswrongitosis actually is, and a mystery about the patient’s identity.
House can never do something the easy way if that would involve human interaction, so he doesn't actually asks the guy. Instead he gets his team to investigate whether he's been on TV, among other leads. "His problem could be neurological. Everyone knows TV rots your brain." In desperation, while the patient is deteriorating on the operating table, House asks the crucial question: "Have you ever appeared in any pornos?"
With all the toilet humor and the opening blow-em-up war scene, this House tilted toward the 12-year-old-boy demographic that consists not just of 12-year-old boys, but most men as well. In doing so, it found new and interesting ways to disgust squeamish me. Did I really need to see House catheterize himself? Just to be clear: I really, really didn’t.
The epiphany to both mysteries comes to House in yet another dream, and the episode has cleverly prepped us for surreality by playing with what's real and point of view, including in an effective scene where we cut from John's deaf perspective to the minions arguing loudly over his bedside. However, I have to admit I didn't follow the medical epiphany in the dream at all, so House’s instadiagnosis of the patient didn't hold together for me. Maybe I was just distracted by the Cuddy-related epiphany. Or by all the urine.
When House's nose begins to bleed, and the TV screen starts to resemble a funhouse mirror, and Cuddy seductively says "I'm always here," it's not much of a surprise when House wakes up in bed. Covered in urine, naturally, but with a satisfied smile on his face. Well sure. It's all crystal clear now.
After going through diagnoses including sleep apnea, an STD, several kinds of cancer, and uranium toxicity, and symptoms including loss of hearing and paralysis, the patient's pallor and blood loss – did he have blood loss? – and the news of his grandfather's nosebleeds and father's shin splints bring sleeping House to the conclusion of a disease I've never heard of and am not even going to begin to try to spell. (Though the FOX website kindly posts information like that, all that cutting and pasting would wear me out.) Somewhere in there was the dream image of House's self-catheterization being exposed by a leak in the collection bag, and inordinate amounts of urine spilling from his pant leg. Have I mentioned all the pee?
House has also clued in to who his patient is. Turns out, he accompanied Cuddy for all of 10 minutes to a hospital function. Those who can’t swallow the idea that House dreamed about someone he saw two years ago minutes before being forced to take him on as a patient (my hand is raised here) are given the more rational solution by Wilson: he inserted the face into the dream in retrospect. The combination of Cuddy throwing him the file and the picture of the patient in that file triggered the niggling mystery in House’s subconscious. Wilson also reveals his disturbingly in-depth knowledge of the Village People as he opines that House's dream was inspired by a desire to mend his relationship with his father, an ex-Marine.
When House indignantly confronts Cuddy over her secret connection to the patient, a sly smile creeps onto her face. "Get over me," she taunts. Besides answering the pressing question of pee, “Top Secret” also gave one of the most satisfyingly juicy revelations yet. It seems there is not, in fact, a great wall of China between love and hate; there was a night of passion in House and Cuddy’s past. This piece of information makes me want to think back and re-evaluate previous interactions to see what the new perspective adds. I see a DVD marathon in my summer.
House: Give me a break. You hired me …
Cuddy: … because you're a good doctor who couldn't get himself hired at a blood bank, so I got you cheap.
House: You gave me everything I asked for because one night I gave you everything …
She finishes it off by pointing out "that ship sailed long ago." And though she appears to have bested him in this exchange, he smiles ruefully, obviously enjoying the tease. As do I.
In "Top Secret," yet another secret is exposed. Cameron has been enjoying her little arrangement with Chase perhaps a little too much, ignoring the patient in the process. Or, as Chase suspects, is she trying to get caught? “I’m over House,” she protests a couple of times. Yeah, right, and clingy and jealous Chase is successfully keeping his emotions out of the uncomplicated sex agreement.
Foreman catches them playing hooky when they're supposed to be monitoring the patient's sleep patterns, though Cameron craftily uses the truth to distract him – that they were having sex in one of the sleep rooms.
Foreman: House'd do Wilson before you'd do Chase.
Cameron: No, you'll do House and Wilson before I'd do Chase. Now can we get back to work?
Chase: She did me once.
Foreman: She was stoned!
Poor Chase. To make things worse for him, House, who's guessed their secret, "accidentally" catches them in a supply closet, saying he was looking for a larger garbage can. "Since when does he clean anything up?" Chase moans. In an episode full of expressive smiles, the one on House's face as he walked back to his office was the evil smile of future tormenting possibilities. If she was hoping to get caught to make House jealous, Cameron's hopes might have been dashed to see it.
So House ends by saving his patient, fixing his pee problem, blissfully ignoring the possibility that the Vicodin is harming his health, and gathering ammunition against Cuddy, Chase, and Cameron. All in all a good day's work for him, if you ignore the fact that the Vicodin is harming his health and he continues to have social skills a 12-year-old boy might be appalled at.