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A potential smallpox outbreak threatens the hospital and House in "A Pox Upon Our House," House, M.D.'s eighth episode of the new season.

TV Review: House, M.D. – “A Pox Upon Our House” in Depth

From the 1950s until the 1970s babies were routinely vaccinated against the often-fatal and highly contagious disease. Many of us can still see the scar left by the vaccine (on the upper arm near the shoulder—it looks sort of like a brown flower tattoo). But smallpox was eradicated from the face of the earth more than 30 years ago; the supply of virus was largely destroyed (small amounts were sent to specific, well-protected labs for research). The decision to destroy the vaccine supply came in the aftermath of the accidental exposure of medical photographer Janet Parker. Which brings us to this week’s House, M.D. episode “A Pox on Our House.”

Julie, a teenage girl, picks up a medicine bottle from 18th Century slave ship wreckage off Bermuda. The slave ship had been sunk because it was believed that the passengers were infected or exposed to the deadly virus. When the girl breaks out in a suspicious rash after cutting her hand with broken bottle, House (Hugh Laurie) thinks she may have smallpox. Despite Foreman’s (Omar Epps) protestations to the contrary, confirmatory tests do seem to indicate that she has it.

House sees something in Julie’s symptoms that don’t’ quite fit a smallpox diagnosis. But in the meantime, the hospital has been quarantined—because it might be smallpox, and the Centers for Disease Control (CDC) comes in to take over the investigation from House and the team, leaving them with little else to do but twiddle their thumbs and wait for results.

Minor rant: Okay, so there’s only one thing that bugged me about this episode. It makes complete sense to call in the CDC, but his complete dismissal of House doesn’t make sense given House’s expertise. House is not only as a diagnostician (he’s world famous enough for the CIA to have called him in on a consult in “Whatever it Takes,” which aired season four), he’s also board certified in infectious diseases (and nephrology).  That’s quite a pedigree to have him shoved aside by the CDC guy like he’s some sort of provincial hospital doc.  On the other hand, maybe the CDC honcho does know about House and just doesn’t like his way of doing things—or maybe he’s just arrogant. It just bothered me a bit – and it bothered me that House didn’t really push it. End of rant, and now returning you to your regularly scheduled House commentary.

Foreman, Chase (Jesse Spencer) and Taub (Peter Jacobson) are content to read the paper and wait out the CDC. But the earnest and eager newbie Masters (Amber Tamblyn) wants to continue the differential. “What looks like smallpox, but isn’t?” is a question we might expect House to ask.

But House isn’t exactly biding his time by doing the New York Times crossword; he’s doing research. The CDC may hold the keys to the quarantine room, but the resourceful House has located the captain’s log from the sunken ship. But it’s in Dutch. Now, I would guess that House has at least a passing knowledge of Dutch, but would not be fluent enough (or fast enough) to translate all that Dutch (especially 18th Century Dutch) quickly and efficiently. Which would explain why he enlists a Dutch cyber-hooker to translate the journal. (Okay, that’s not the only reason!)

The historical perspective places House on another path, but neither reason nor manipulation get House anywhere with the CDC doctor. Although House considers that the African men who got sick on the ship actually died of cervical tuberculosis (scrofula), he can’t really get near enough to test the theory before Julie’s dad keels over in pain.

House plans a sneak attack to get a needed head CT, but humoring Masters, he lets her try using her more honest approach. Surprising (to House, anyway) it works, but before they can transport him, he shows yet more symptoms, with more evidence for smallpox—less for the “scroffulicious” cervical TB.

But after the dad develops pustules, even House is convinced that Julie and her dad both have smallpox—for the moment. But soon, House sees something else that doesn’t fit after Masters notices that Julie has no telltale pustules on her palms and soles of her feet. House believes that the dad is reacting to the smallpox treatment he’s been receiving, but the CDC doc isn’t buying House’s earnest argument, to which he seems just as immune as he would have been to House’s “Jedi mind tricks.” (I had to get that in, along with Hugh Laurie’s spot on Obi-Wan Kenobe impression.)

But House defies the CDC doctor, exhibiting his own brand of arrogance by slipping into the quarantined room. House knows it’s not smallpox, therefore there’s no danger. Right? But his meds don’t work and as Dad dies, House realizes he may have condemned himself by his own misguided self-confidence.

After he tries futilely to revive the dad, the fight evaporates from House as he begins to understand the consequences of his actions and the inevitability of his own death. He is cornered, doomed either to die of smallpox contracted from the dad before he donned the hazmat gear, by asphyxiation once his limited air supply runs out or by exposure if they dare to swap out his Oxygen canister. There are still hours to go before the lab results come back.

Although House is helpless trapped in isolation with the Dad’s still oozing corpse, Masters becomes House, refusing to give up the fight. After reconnecting with House’s unusual translator, Masters learns that the ship captain’s cat lost its fur and died. Now viewing the problem as House might, she goes to the isolation room window to convince him it’s not smallpox after all. Appealing to him in a way she believes will get him to get outside himself, she gets House to snap out of it and take the very dangerous yet necessary risk of removing his gloves to inspect the highly infectious corpse in the room. And it is only by so doing that House notices the eschar signature of the rickettsial infection; something unique to that, and not to smallpox.

Running parallel to the medical story, House and Cuddy’s (Lisa Edelstein) relationship continues to confront its own challenges when House suffers the consequences of lying to Cuddy in last week’s episode “Office Politics.” Cuddy would expect House to lie, cheat and steal for “the answer” and to save the patient. But perpetuating the lie after the fact, and after the patient had been saved, maybe not so much. House usually comes clean when confronted, and last week he didn’t—probably out of fear for Cuddy’s reaction. So, he compounds his lie by not admitting it when he had the chance. And Cuddy is hurt by that.

House first realizes that something’s up when she chases him from the clinic. Cuddy is miffed and doesn’t want him anywhere around her. And when he asks about it, House is astonished she hadn’t confronted him. But she had been “waiting” for him to act—and apologize; something he doesn’t believes he owes her. It’s business, he insists and nothing personal.

House doesn’t understand why she’s unable to compartmentalize their business and personal relationships. So they are at an impasse until House recklessly lets himself into the patient’s isolation unit—without a biohazard suit. All is forgotten as Cuddy worries whether House is actually in real danger of succumbing to smallpox. Despite her anger and his annoyance, there is sense that none of that matters while House’s life is in danger.

Even when they go back to status quo: House annoyed and Cuddy angry, there is no real sense that this is anything other than a relationship obstacle that can be overcome, if not completely eradicated. Cuddy cares enough about House that she stays at the isolation unit window as close to him as she can be. And House’s “I’ll be right back” when he has to momentarily leave his window perch is a quiet plea that she not leave. It’s a somehow very intimate little moment in the chaos of the crisis.

I like Cuddy setting this line in the sand. She understands what House sometimes needs to do (even lie to her), but what he did was disrespect her in a way that’s intolerable. I don’t think he did it to hurt or even to perpetuate the lie for its own sake. House acted out of fear of how Cuddy would react, and now suffers for it. But at least they are talking about it, arguing about it.

Will Cuddy stay angry? And what will House do to ameliorate the tension between them? That’s left for next week to ponder as they attend a wedding. But I really like that there is no pat, easy answer for them; no breakup and no quick reconciliation even after House puts himself in such danger. There’s no makeup sex or longing glances. As soon as the danger is past, the tension resumes. It feels real (at least within the House-universe), and I like it.

Lawrence Kaplow’s intricate, tightly woven script makes this one of the best House episodes of the year. “A Pox Upon Our House” weaves together themes of family, bonding, honesty and how we react to a crisis sometimes changes dynamics, if only temporarily. Families form and stumble awkwardly toward the next inevitable step as life: living—and dying—changes things.  A random act connected to a 200-year-old event necessitates the formation of an entirely new family; Wilson and Sam’s unexpected stint babysitting a sick child leads them to wonder if they have what it takes to deal with having children.

Love trumps anger between partners in times of danger, but what happens when the threat passes? Almost dying, as House has said, changes everything—but not for long.

In case you haven’t noticed, I’m really liking House, M.D.’s newest character, Martha Masters. I’ve been trying to pin down why I like her so much. I’m usually annoyed with characters who are “as smart as” House because no one should be smarter than House. So what’s going on?

One of the best things about her is that she doesn’t dismiss House, but she also hasn’t drunk his Kool-aid. She’s brave enough to challenge House without his provocation, idealistic enough to insist that moral outlook is sensible and right, and self-assured enough to push her own theories without prompting.

A medical student, but one with two PhDs under her belt, Masters, like House has a larger universe from which to draw inferences and obscure references. She sees the way House sees, putting together disparate bits of truth and clues. She buys into House’s way of thinking, but not his modus operandi. She loves the game in the same way he does; she wants to rescue the dying in the same way House does. So when House is in isolation, she completely buys into House’s use of the Dutch hooker to translate and goes back to her for another piece of the puzzle. We’ve never had a character on the show quite like her. And since all the characters reflect House in one way or another, I find her especially compelling.

Next week’s episode looks great, and no I don’t have access to a review copy this time, so I will be watching with everyone else come next Monday night. And for those who have enquired, a video of my television appearance on Fox’s Chicago affiliate to talk about the series, this blog and Chasing Zebras: The Unofficial Guide to House, M.D.

About Barbara Barnett

Barbara Barnett is Publisher/Executive Editor of Blogcritics, (blogcritics.org). Her Bram Stoker Award-nominated novel, called "Anne Rice meets Michael Crichton," The Apothecary's Curse The Apothecary's Curse is now out from Pyr, an imprint of Prometheus Books.Her book on the TV series House, M.D., Chasing Zebras is a quintessential guide to the themes, characters and episodes of the hit show. Barnett is an accomplished speaker, an annual favorite at MENSA's HalloWEEM convention, where she has spoken to standing room crowds on subjects as diverse as "The Byronic Hero in Pop Culture," "The Many Faces of Sherlock Holmes," "The Hidden History of Science Fiction," and "Our Passion for Disaster (Movies)."

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