Lies are at the heart of so many of Dr. Gregory House’s (Hugh Laurie) cases: lies patients tell doctors, tell family members, and tell themselves. In “Family Practice,” this week’s latest House, M.D., episode the lies are compounded because family and medical treatment are wrapped up together along with the emotional relationship between of the patient’s daughter, Lisa Cuddy and her doctor (House, of course).
Arlene Cuddy (Candice Bergen) is out clothes shopping with her two daughters Julia and Lisa. It is apparent even from this moment that Arlene’s relationship with Lisa’s sister Julia (guest star Paula Marshall) is much closer and more cordial. But when Arlene begins to feel “funny” in her heart, Cuddy (Lisa Edelstein) puts on her M.D. and gets Mom to Princeton Plainsboro, suspecting it’s more than simple palpitations.
Knowing that Cuddy wants him to treat Arlene, House hides in the morgue with the rest of the team. “You don’t want me to treat her,” he argues. “You don’t want you to treat her.” House recites to her the ethics of why it’s a bad idea to treat someone with whom you have an emotional connection. And he’s right. But he allows himself to be talked onto the case to appease her.
Cuddy wants the best for her mother, and a staff cardiologist just won’t do. House is willing to go along (barely), sending the team to check out Arlene’s house, where they find the possible culprit—along with some very revealing photos of Cuddy’s mom. She’s been having a hot affair for years with a married man—something about which she’s never told Cuddy (but Julia knows all about it).
House’s initial diagnosis is lead poisoning, writing off the rest of Arlene’s symptoms to hypochondria. And sooner rather than later, House manages to piss off Arlene enough to insist he be fired from the case.
This is just fine with House, who doesn’t believe they should be treating her anyway—only doing so as a bit of self-preservation. But when it’s clear that there is something wrong with Arlene, Cuddy insists House continue working on the case behind the scenes and behind the back of the new attending physician, Dr. Kaufman.
Cuddy’s request and House’s willingness to go along with it set off a series of events nearly ending in disaster, and feed the episode’s central question about family conflict and confrontation. Arlene controls Cuddy by blunt truths designed to sting and keep her just this side of parental disapproval.
“We just don’t have that sort of relationship,” explains Arlene to the hurt Cuddy when she learns of Mom's affair. That's why she confides in Julia, leaving her other daughter out in the cold. “Does it really surprise you?” she asks. And later in the episode, Arlene zings Cuddy with one of the most devastating things a parent can say: "I love you both, but I like her better." Ouch. Bullseye.