TV Review: House, MD – “Meaning” (Revisited)

There is a scene at the beginning of the season three House premiere, “Meaning,” that reveals a healed Gregory House (the brilliant Hugh Laurie). Graceful and quick, he runs through a park, free of pain and the shackles of disability. It is but a brief glimpse, and by the end of the episode, we know that for House, it will be (as Wilson will say by episode two) only a taste of what is not meant to be. And by midway through the season, House will have crashed and burned, reaching the depths of despair.

Throughout “Meaning,” House struggles with himself and his colleagues to find his sense of self in his new reality, having gone through dual life-changing events: being near fatally shot and attempting a radical therapy to rid himself of pain (and get himself off of pain killers). Convinced after his fevered hallucination in the season two finale “No Reason” that he lacks humanity, House accepts a brain-damaged quadriplegic cancer patient for the sole purpose of helping him with pain, almost daring himself that he can find “meaning” in normal “doctor stuff.” But he can’t quite figure out how to react when the patient’s family thanks him. In House’s mind, he’s done nothing; he hasn’t cured the patient or done anything significant. Confused, House believes he should “feel” something, and he doesn’t. He confesses to Wilson: “I wasn’t even sure what I was supposed to feel."

Wilson tells him, rightly, that House doesn't have to do or feel anything different, but should appreciate it for what it is. He need not change anything. It's a matter of perspective, he suggests by his words. He believes that House is trying to force himself to be something that he is not, and that it's not necessary. Wilson tells House that he simply has to learn to appreciate what he already does for people. I like this Wilson, who was on the right track for that brief moment, before he went on to tell House to work his “caring” muscles; “the feeling will come.”

House seeks answers about “caring” from the patient’s wife, asking her why she doesn’t put him in a nursing home. What does she get out of her self-sacrifice? It's as if House is trying to understand this level of devotion and compassion for its own sake. She's "sacrificing (herself) and gets nothing in return…" Why would she do that? Does it make her happy? Fulfilled? No, she explains. But not doing it would leave her even emptier. In House's “No Reason” hallucination, Moriarty tells him that he sacrifices himself for “no reason.” House wonders how the wife can derive something from what he sees as a miserable life. Can he apply this to his own life? Does House need to do what he does best to keep himself from being even more miserable?

While House wends his way through this uncharted territory emotional territory, everyone suspects that he has an agenda; that he’s playing with the patient for his amusement, creating a puzzle for himself where there is none.

Not satisfied with leaving the patient and his family with the status quo, House considers the possibility that the patient’s paralysis might be something curable after hearing the patient grunt (which House translates as speech). But everyone attacks House’s motives. Cameron mocks him; Cuddy accuses; Wilson lectures and scolds. Meeting House at the park, Wilson accuses him of fabricating a mystery for his amusement.

"You didn't tell the wife it was just a grunt?"

"No, of course not."

House retorts that he's built them up with too much false hope and can't let them down, playing up his image as a jerk. It’s a safe fall-back position for him. But in his encounters with the wife and the patient, there is nothing in House’s demeanor, body language or remarks that suggest anything other than sincere belief that the paralyzed, wheelchair-bound patient has something curable. And that there's a chance that his quality of life for both patient and family will be improved. There is an idealism in House's approach to medicine that comes out in moments like this.

At the same time, House’s begins to fear that the ketamine treatment is failing. Skateboarding in the park, House feels a sudden pain in his thigh. Clearly unnerved by this sudden pain, House confides his fears to Wilson, asking him to write a prescription for pain medicine. Dismissing House’s soreness as “middle-aged aches and pains,” Wilson suggests that House is scamming him. I think Wilson’s wrong. If House is concerned enough to tell Wilson, it's got to be either bad or extremely frightening. House has been riding high on his newly pain-free life, suddenly able to do (physically) what he’s been unable to do for years. The return of the pain probably is his deepest fear.

As House leaves his office, Wilson finally acknowledges the extent of House’s fear, reassuring that procedure worked and that it will just take some time to feel good again (in all ways).

There is a second running scene in “Meaning,” a stark contrast to the joyful opening scene. Starkly shot and darkly atmospheric, it is devoid of the the first scene's promise and hopefulness. The gracefulness of the first running scene is replaced by desperation; House is running away — from his fear; from his demons.

But House has an epiphany about his patient, and, late at night, taps at Cuddy’s window, waking her. I loved seeing House, breathing heavily, hot, exhausted, talking a mile a minute, running (not walking) Cuddy through his scientific reasoning. He is excited, delighted and, as Cuddy says, high.

"I can make him walk, I can make him talk!" House implores Cuddy. ("I can help him — I can make his life better — I can make his family's life better" — this is what he's really saying.) This is the “fulfillment” that House gets; this is the joy and satisfaction he derives from the diagnosis. Yes, the final piece of the puzzle falls neatly into place, but it’s meaningless to House unless it means something to the patient, unless he can send the patient home better off than when he came onto his service. This is ultimate job satisfaction for House.

But Cuddy shuts him down, believing that House has to learn when “enough is enough.” House’s self-esteem is completely tied up in his ability to make inspired connections between disparate facts that no one else can. Taking that away from him, which is what Cuddy is doing here, strips House of the very thing that makes his medical value unique. If they can't let House be House, then who is he? With Wilson, Cuddy, and Cameron all accusing House of playing at some sort of game with a traumatized patient, and in light of House’s own fear of the ketamine’s cognitive side effects, his own confidence begins to unravel.

Worn down by a combination of his own confusion and the barrage from his closest colleagues, House is convinced that his motives and judgment are wrong. He broods in his office the next morning, depressed that he’s failed not only the patient, but his own impossible test. “Cuddy was right; I was only in it for the puzzle,” he confesses bitterly to Wilson, his voice tinged with self-loathing. “She was right to shoot me down.”

Wilson has oft stated that House’s success is all about luck, and this plays out in the final scene, as Cuddy herself uses House’s treatment on the patient. House was right; but Wilson insists they not tell him, in order to rein him in. I have never felt worse for House. And, in my opinion, nothing can justify this action. The short-term result is to leave House feeling both isolated and desperate. And it sets him on a path that will lead to nearly tragic consequences by Christmas (“Merry Little Christmas”).

Hugh Laurie does a magnificent job in this episode (but when does he not?) revealing the conflict raging in House, as well as his delighted joy and the depths of his despair. So much happens in this packed episode that it's easy to ignore the effortless range of Laurie's performance in it.