At the end of the season two House, M. D. episode “Distractions” (2×12), House (Hugh Laurie) has a conversation with Cuddy (Lisa Edelstein) about balance in the universe. Having just settled an old score with a medical school rival, House says, “An eye for an eye, LSD and antidepressants. Everything in balance. Buddhists call it karma and Christians call it the golden rule.” But Cuddy wonders if House actually believes that this is the way the world works—that the world is just, when he clearly does not. “No,” he answers, “but it should."
In a way, “Instant Karma” reminded me of an “old school” season two House. The original team is back and working together on a great medical mystery. We’re reminded that House is the best: a legendary diagnostician, better than the best money can buy. People seek him out on sheer reputation.
He is confident in his diagnoses—all of them. And even after he diagnoses a fatal illness, House continues to turn the case in his head, at least subconsciously in his mind. Until everything clicks into place, as it should, in the last few minutes of the episode.
Cameron (Jennifer Morrison), Chase (Jesse Spencer), and Foreman (Omar Epps) do what they do best and their synergy in diagnosing their young patient seems to still fit comfortably. Taub is gone, resigned two weeks ago, disinterested in working for Foreman. And 13 (Olivia Wilde) has also quit, not wanting to be anywhere close to Foreman’s orbit.
But a lot has changed in House’s world since the end of season three when the original team breaks up. Everyone’s more world-weary: House is still recovering, and still without a medical license. He seems to like not being in charge and is in no hurry to be the boss again (at least that what he believes), but as Chase ultimately tells him, no matter who thinks they’re in charge, House is the boss—and always will be. And it shows throughout “Instant Karma.”
It is so good to see House back in the front seat, if only with Foreman at the wheel (or at least controlling the brakes). House makes light of this new arrangement, enjoying the freedom of being the star, without the responsibility of liability lawsuits or administrative duties.
The patient, the young Jack, is a child of privilege. His father Roy is a Midas, and everything he touches turns to gold—except when it comes to his family. But he also wonders about the connection between his golden touch and the terrible losses he has suffered personally: first his wife and now his son. How can one be so lucky in one area of life, and so unlucky in everything that really matters?
Jack has been seen by many doctors, none of whom can identify what’s wrong with him. At a loss, his father goes to Cuddy, demanding to see House.
House is calm, thoughtful and introspective as he considers what they can do, what they’ve done and what they learn—and can improve upon as each treatment fails. This is classic House. You try something, it fails, a new symptom or reaction presents—and you learn something else to guide the next step in the diagnostic process. And the process runs smoother than it has in a couple of weeks, without everyone arguing and jockeying for position. This is House’s show, and even without the white board (anyone else notice its absence since the start of the season?) he commands the team.
But House isn’t so sure he wants it back. House wants Foreman to stay in charge, he explains to Cuddy, because Foreman likes power and he like puzzles (for a nice balance). But Cuddy reminds House that he likes power too, something House doesn’t dispute. However, he’s worried about that combination and how it sets his balance off: the combination has not been healthy for him, and he has no desire to go there again. He wants the balance this new arrangement will afford him.
When House ultimately diagnoses a fatal condition in Jack (and in another classic move, House chooses himself to speak to the dad—he knows what to say, compassionately, without sugar-coating), his father is willing to give everything up to save his son, even if what he proposes seems insane.
Believing his wife’s earlier death and now his son’s imminent death are caused by an imbalance with his incredible good fortune in business, he decides to bankrupt himself. He believes by evening up the score, he might save his son. It’s completely irrational, but the grief-stricken father knows if his son dies, no amount of money in the world would be worth having.
Of course House knows this is nonsense. “People don’t get what they deserve; they get what they get, and nobody can do anything about it,” he tells Roy before he signs away his fortune. And House is right; but Jack lives, when House has an epiphany while speaking with Wilson (told you this was “House-classic”). So who is to really say?
As the team works to save Jack’s life, Foreman and Chase prepare to present President Dibala’s death at the hospital's weekly Morbidity and Mortality Conference. These conferences are designed to take a closer look at a patient's death and try to understand what happened; and as a teaching hospital the presentation is designed to educate the staff and medical students alike.
Of course a high-profile consideration of the Diabla case is the last thing Chase and Foreman want; Chase, if you recall, deliberately falsified Dibala’s records, which caused the team to treat Dibala for the wrong condition—and killing him. Covering for Chase, Foreman burned the evidence. But, as they prepare for the presentation, they are both concerned for their careers as they discover a discrepancy that may reveal their deception.
House is immediately curious when he observes Foreman and Chase constantly conferring, especially to the exclusion of Cameron. House knows something’s up. And as soon as he figures it out, he makes it right—for everyone. He saves the careers of Foreman and Chase; and perhaps Chase’s marriage to Cameron. (If she ever finds out about the assassination or the lies to cover it, she and Chase are toast as a couple).
Of course, House fixes it quietly, wanting no thanks or any such acknowledgment. He simply leaves relevant information where Chase can easily find it. And in the end, although House could very easily mock and berate Chase—or make certain he is fired—for what he did, House does not. I think he probably respects Chase for having taken a stand, and acting on it, no matter how misguided he might have been.That scene between Chase and House is just beautifully done. There is a real affection between the two characters, and Laurie and Spencer really sell that.
I was curious about the interaction between House and 13. House prevents her from leaving (conspiring with Wilson to conceal his act) on an open-ended trip to Thailand. If she stays—and goes back to Foreman—House will likely regain control of the diagnostics department, because Foreman can’t be 13’s boss and her lover.
But if she leaves, Foreman stays on as department head (theoretically, although I doubt Cuddy would allow this long term). House can continue being the star player without the baggage of running things. Then why save the 13/Foreman relationship? Wilson believes he is simply trying to help out the young lovers, because he is “not as big a jerk” as everyone thinks he is. Of course House denies this, pointing out just how big a jerk he really is. (Ah, the balance of it: House does something altruistic for Foreman and 13, and then plays the stock market on insider information gained from Roy.)
Much of this episode is about restoring balance: to the diagnostics department; to the mess made of the Dibala affair; to Jack and his father Roy, shattered by terrible illness; to House after a terrifying and tumultuous three months; and to the relationships between all people in House’s universe. And as it should, House becomes the fulcrum in each of these dimensions to begin a restoration of everything in his universe to its correct balance. Which ultimately means, naturally, House is back in charge of diagnostics—but at what cost?