TV Review: House, M.D. – “Selfish” in Depth

“Selfish,” the second episode in House, M.D.’s new season brings us back to basics in the House-verse after last week’s off-formula and wonderful “Now What?” But House (Hugh Laurie) and Cuddy’s (Lisa Edelstein) relationship plays a prominent role as they try to figure out just how it’s all going to work—at work. We get a great medical case with an interesting ethical dilemma—and a perfect return to those “clinic beats” we all crave.

As I said in my preview, I think (if The Powers That Be continue
along this path) we have little about which to be concerned. I see no sharks preparing to jump. In fact, quite the opposite. I believe that this romance—relationship—has the ability to once again recharge and reinvigorate the show, taking House’s journey (which is, after all, the core of the narrative) in a new direction with fresh challenges, obstacles and angst to deal with. It’s going to be quite a ride, I’m sure.

This week’s patient is Della (Alyson Stoner), a skateboarding teenager; her brother Hugo (Tony Saintgenue) has “severe congenital muscular dystrophy,” a disease that will shorten his life expectancy to 25 years. During a fundraiser for the disease, Della collapses while pushing her brother through the skateboard track, presenting to House and the team with an intermittent heart arrhythmia. 

House is waiting for Cuddy when she arrives at work. Taking her hand, he is ready to conquer the world (and tell everyone) with Cuddy at his side. But Cuddy wants this all above-board and by the book; that means reporting it to Human Resources and signing a “love agreement.” 

And true to form, although he promises Cuddy that he will not tell anyone about their relationship until they’ve been in to see HR to discuss, House’s excitement cannot be contained for even a moment, as he tells his shocked fellows (and a highly skeptical Wilson, played by Robert Sean Leonard) that he and Cuddy are involved.

Taub (Peter Jacobson) isn’t so sure this all is a good idea “yanking on the chain of command.” Foreman (Omar Epps) actually thinks the romance is a good thing, and Chase (Jesse Spencer) chooses to ignore it entirely, preferring to focus on the case at hand. Wilson’s disbelief is a carry-over from last week’s episode when he was certain that either House was hallucinating or yanking his chain. But Cuddy’s ultimate proof is brash, bold and undeniable. 

As much as this entire journey will be for House a greater emotional risk—a far greater emotional risk, since it has been so long since he’s been involved. I hear in my head, Wilson’s admonition to Cameron back in “Love Hurts” about the potential fallout if things don’t work out. 

On the other hand, it is six years later and House’s psyche (“therafied,” drug free and anti-depressed as it has been for a year) may be able to better withstand the rocky shoals of a real relationship than he has been in years. For Cuddy, the risks are different but just as great. As dean—and House’s boss—she needs to prove both to herself and the hospital staff that she can rein in the village maverick. But she also needs to prove to House that she really can control him. He is so good at finding the weak spots, that if she doesn’t show him right off that he can’t get away with more than he had before, chaos will reign.  

Interestingly House has no interest in testing Cuddy’s authority nor the bounds of her position as his boss). House is solicitous to a degree not seen since the end of season four. Astute fans (and my readers are among the most astute on the planet) should recall another time when House has been so destructively deferential (and against his better judgment). That, of course, was in “Wilson’s Heart,” at the end of season four.

Back then, House was concerned about Wilson. Over and over in that episode, House backs off the riskier (and perhaps more effective) choices to resist making waves with Wilson (and perhaps risking their relationship). 

Cuddy is taken a bit taken aback at House’s compliance. You would think she would appreciate this new and more malleable House, but she seems unsettled by it. And this forms the core conflict of their first week as lovers as they grapple with how their relationship can possibly, and at all, work while keeping the hospital standing and the relationship secure. “I just don’t want our relationship affecting our jobs—or the other way around.” 

When Della requires a lung transplant and her body rejects the donor lung, the 14-year old and her parents are faced with an impossible choice. Della’s brother is a match, but a donating such a significant organ may cut his lifespan even further, perhaps in half. Do the parents ask this of themselves and their son—or risk losing both of them: Della immediately and her brother within a few short years? 

Although Della is willing to be martyr for her brother, saving the few years he has left in a selfless sacrifice of her own. But what effect would her death have on Hugo? Far from being a selfless act, dying would leave Hugo without a sister—someone to live life in a way he cannot—through whom he can live a vicarious and exciting life.  

This is the type of ethical choice House (and House) is especially good at, but his new relationship with Cuddy at stake, is House willing to “do what needs to be done, rules be damned” if that mean creating conflict in the fledgling romance? Throughout the episode, House tries so hard not to step on Cuddy’s toes, Taub observes the short leash Cuddy has lassoed around his neck. House realizes that he is being overly deferential; he knows the relationship is affecting his medical decisions, but can’t help himself. He wants so desperately for the relationship to work, he’s second guessing himself and tiptoeing around choices that might upset her.

Deferring to Cuddy—refusing to engage her in debate, arguing his cause or going around her back frustrates the team—and eventually even frustrates Cuddy, because it gets them nowhere either with each other or with the patient. And if it keeps up the entire relationship will implode. 

In a pivotal scene, House wants to do a risky procedure on Della, Cuddy approves the procedure, but House senses that she opposes it. Pulling his punches, House goes with a less risky procedure. It works, but as Taub insists, it might not the next time. Second guessing himself to please Cuddy is not the way to run his practice. But how to make it work—and make things with Cuddy not contentious?

And although they seem to be selfless, each afraid to make a move to oppose the other, House and Cuddy are also being selfish. As they guard their relationship, just beginning to blossom, they nearly blow apart the case. House, afraid to do what has to be done, rules be damned for fear of ticking off Cuddy, feeling compelled to defer to her, and Cuddy afraid to rein in her reckless-prone doc finally come to their senses and act as if they had no intimate relationship at all, perhaps the riskiest—and most selfless act possible. 

Precipitated by the parent’s decision not to allow a lung transplant from Hugo, House blows up (finally), pointing out as only House can, the idiocy (and bad math) of their decision. But the decision is removed from them when Hugo overhears the blow up and insists against his parents’ wishes (and Della’s) to donate part of his lung: a selfish/selfless act. The resolution is incredibly satisfying when Cuddy and House start arguing the ethics of the situation and blow up at each other. As Cuddy says, it’s the most honest they’d been with each other all day. It clears the air between them, and gives each (and their relationship) room to breathe. 

Another thread of the “selfish/selfless” theme emerges when House is plopped into a family conflict when an elderly man brings his even more elderly father into the clinic. The son wants House to insist that Dad be placed in an assisted living arrangement. He’s tired after all these years of being parent to his father. For once, he wants to be “selfish.” 

Unbeknownst to him, Dad, too wants to be rid of his hovering son who “can’t let go” and also asks House “selfishly” to be recommended for the old folks’ home (a private suite with all the trimmin’s). Over the course of the series, House has been forced into these little family situations, where a little Housian honesty might go a long way to make everyone a little less miserable. This clinic beat is classic, appearing several times during the episode. 

Even the team exhibits selfishness in the their reactions to House and Cuddy’s news: Foreman thinks that  a happier House is a less harsh boss; Taub, who enjoys the excitement of their practice sees no good if it mean House will play it safe and let Cuddy keep him on a short leash. But is House right when he suggests Taub’s concern might be more selfish? Does Taub like the miserable company that House provides, and if that’s gone, is Taub sitting on that limb all by himself as House suggests?

Next week, Amy Irving guest stars as a children’s author in “Unwritten.” More about that, hopefully, later in the week. Stay tuned!