Wilson confronts House about the missing patient, berating him that stealing a sick man is not the same as stealing a guitar. What if the nurses gave his patient the wrong meds and there we have it… the Aha! moment. We can literally see the light bulb above House’s head as he realizes that is what’s been wrong with Megan all along.
House goes back to Megan’s room with another chart. The mother asks what he is doing to Megan and he coldly says, “Nothing.” He explains Megan is not feeling anything at all, because the girl in the bed is not Megan. She is another similarly featured girl who was in the building with Megan when it collapsed. The chart he brought was for the other girl whom everyone assumed had died in the hospital the day before. She had been on antidepressants, had an abortion, and was on the pill. It was Megan that had died. He proves it by removing the tube from the girl’s throat and asking her name. The girl whispers, “Liz.”
The genius of this plot twist is that the audience gets to feel the anguish of Megan’s loved ones. Throughout the episode, we were given bits and pieces of the patient’s story to the point were we are emotionally vested in her outcome. We experience the frustration of the family as Megan’s health deteriorates but we still hope that House will cure her. That hope is thrown back in our faces by a bizarre twist of fate. Someone was saved, but she was a stranger.
And worst of all, but sadly true to character, House didn’t care. In what could have been a poor attempt to comfort the boyfriend at the discovery of this tragic mix-up, he said to him, “Your girlfriend never lied to you.” Even for a fan-girl like me, who feels that House can do no wrong, it came off as callous and uncaring. This brings me to the third missing item from the episode: the little spark of humanity that House keeps hidden from the rest of the world. This was not the House who argued with a patient in the pilot to choose to live with dignity because death is always messy, nor was he the House who heroically lied to a transplant board on behalf of his bulimic patient who needed a new heart, or helped the vegetative state guy protect the heart he wanted to donate to his son when he committed suicide. This House was truly an uncaring bastard who bragged to his boss that he solved the puzzle all by himself.