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House, M.D.'s latest episode explores faith, trust and the "small sacrifices" necessary to in make relationships survive.

TV Review: House, M.D. – “Small Sacrifices”

Belief in God is an oft-revisited theme for House, M.D. and its atheist anti-hero (played with grace and depth by Hugh Laurie). From nuns and disillusioned priests to faith healers and the nature of miracles, the series has skewered religious hypocrisy and ritual, but has also asked some interesting questions about the nature of God and belief along the way.

“Small Sacrifices” features a fairly straightforward medical case to frame the real story of the episode, which explores the nature of relationships: mortal and divine. What’s required to make a relationship work—and what’s not? One of those relationships is with God.

This week’s patient Ramon Silva (Kuno Becker) had long ago made a deal with God. He prayed that if his daughter, afflicted with glioblastoma—a terminal cancer, would be spared, he would each year pay for her life by nailing himself to the cross (literally) in homage. It’s a gruesome price to pay (and would God, if God exists, require such a harsh payment?).

But now Silva is dying and the only thing, seemingly, that will cure his condition is by using embryonic stem cells, something our patient believes would violate God’s laws. “Accepting this treatment will be affront to God,” he insists.

I have always been taught that we as human (and even more so as parents) are God’s partners here on earth. So the patient believes God would want him to leave his child without a father (after she has already suffered so much) rather than undergo a stem cell transplant to save his (and possibly her) life strikes me as an essential misunderstanding of God, so often at the core of religious extremism. And, as his daughter says, who would want to believe in such a cruel God who requires annual punishment and even the life of a father as payment for saving the life of his child?

Compare Silva, for example, to the season four patient Roz in “Don’t Ever Change.” Roz and her husband are deeply religious people steeped in tradition and ritual. Yet, they are not extremists. Life is sacred, and even violating God’s critical command regarding Sabbath (something very important to the patient and her husband) is trumped if it means saving Roz’s life.

But Silva’s annual crucifixion and potential martyrdom portray just the sort of religious extremism that House loves to mock, and he does so freely (and pretty harshly). He eventually tricks Silva into the procedure by “proving” to him that his daughter was never actually freed of the glioblastoma: hence God never cured her. House shatters the man’s faith to the point where he is willing to let House do whatever is necessary.  It saves Silva’s life—and very likely his daughter’s faith.

The daughter begs her father not to die this way(. How can Silva know God is not talking through her: that her pleas aren’t God’s? How does Silva know God hasn’t sent House to him to save his life; or that those who invented embryonic stem cell procedures aren’t weren’t inspired by God?

By allowing himself to die rather than be treated, Silva is essentially committing suicide, and I wonder what God would think about that? He would also be murdering his daughter’s spirit, and likely her faith. She wonders through her tears how anyone could believe in a God so cruel and heartless preferring her father kill himself rather than stay alive to raise her. “If God could do this, I hate God,”

But Silva’s faith reaches a crisis point when House tells him that his daughter’s cancer was never really cured. Silva bails on God, feeling betrayed for his sacrifice. His simple faith is insecure, a quid pro quo needing to be hammered home each year (so to speak), but easily broken.

His refusal to allow the stem cell treatment has nothing to do with his bargain—only with his own belief that embryonic stem cell treatment is abhorrent to God. Yet, when he understands that his daughter still has cancer—that God did not live up to his expectations, Silva quickly gives up on his beliefs. Yet, when House shows him that his daughter’s cancer really is in remission, Silva proclaims that God is merciful in spite of it all, his faith renewed.

As is often the case, the patient reflects on the other story threads in the episode. “Small Sacrifices” examines crises of faith in several other relationships: Taub (Peter Jacobson) and Rachel (Jennifer Crystal), Sam (Cynthia Watros) and Wilson (Robert Sean Leonard), and House and Cuddy (Lisa Edelstein). I love the contrast of relationships portrayed in David Hoselton’s densely packed script. The three couples, and even House and Masters (Amber Tamblyn) all grapple with the equilibrium between honesty and causing pain; between too little truth—and too much. Faith in your partner, faith in God, faith in knowing you’re doing the right thing are all in play along with the “small sacrifices” we all must make to keep relationships alive and working.

Three episodes ago, House lied to Cuddy to save a patient’s life. House lies all the time; Cuddy knows he lies, and she also knows his lies are usually in the best interests of his patient. She goes along with his lies. She even respects that he does it for the reasons he does. When House lies to her in “Small Sacrifices” she barely blinks an eye, although the lie included forging her signature. Yet, three weeks later she is still angry about a lie told to save the life of a patient. Why?

She is upset because had been dishonest with her about the lie. Convoluted? Perhaps. Yet, it makes some sense. The fact that House assured her that he was being honest when he wasn’t shows her personal disrespect. There is no medical reason for the lie; no life to be saved. The nature of it hurts her in a way that his usual lying never would. House does not understand this completely irrational, yet completely believable truthiness dichotomy Cuddy has staked out. She has insisted that House apologize, and until that, House metaphorically sleeps on the couch. I use that term with good reason.

They have not walked away (or even stepped back) from their relationship. This is an argument—not a breakup. She still insists that he escort her to a wedding (and rehearsal dinner), and he does so willingly. He doesn’t try to manipulate it to meet an ends. It’s very matter of fact. As they get ready for the dinner—and while they’re arguing—House does up her dress without missing a beat; he holds her purse. She expects it and doesn’t even have to ask, like a long married couple having a tiff. (I’m completely reminded of a similar pre-dinner scene in Hugh Laurie’s 1993 movie Peter’s Friends when he zips Imelda Staunton’s dress mid-argument.) It’s a “couple” thing to do.

What I find wonderful and so notable about this is that it’s so normal. As much as House and Cuddy are feeling their way through this particular minefield, there is no sense of impending break up; no stalking off; no unwillingness to work it out. House is trying (in his own inept way) to make it better. It’s completely true to character that he’s not.

The argument is a different matter altogether. House endeavors to play a game of moral relativism with Cuddy, trying to trap her in a lie that would make them “even-Steven;” he fails over and over. There is no moral equivalence to be found. Until. Until he finds just the right way to prove his point and only succeeds in hurting her. He wins, catching her in a lie she’s told him; but it backfires completely. He has unearthed something profoundly personal and secret that it clearly upsets her to have to reveal the truth of it.

In the meantime, Wilson has decided to propose to Sam and re-marry her. This comes in the midst of a clinical review of Sam’s treatment records. While helping Sam by doing a pre-review, Wilson discovers that she’s made dosing errors in radiation treatment of terminal patients. House also observes the errors in her records. But House postulates that her errors aren’t really errors, just intentionally made dose adjustments, going outside the bounds of normal practice to help the patient. It’s something certainly that House would do; so why not Sam?

Whether House believes it or not (I don’t know that he thinks of Sam as that risk-taking in her practice), Wilson sees an out. And (of course) he has to say something to her in a wink-wink, nod-nod sort of way, casting her actions as noble and showing him even more why he loves, admires and respects her.

But Sam has no idea what Wilson is talking about and resents that he doesn’t believe her—have faith in her—when she tells him her dosing is completely correct. Her faith in him is shattered because she believes he doesn’t trust her. They argue and Sam leaves rather than stay and work it out. Is she just in shock that Wilson has proposed? Is she being scared off of repeating the mistakes of the past? And Wilson doesn’t stop her, saying nothing to heal the rift. Their relationship is fractured; the basis for the relationship isn’t firm enough to withstand the crisis. (Of course we don’t yet know whether this is it for Wilson and Sam, but I’m guessing that’s the last we’ll see of her. 

Rachel and Taub, who seem forever confronting the demons of their marriage are once again facing a crisis when “the chickens come home to roost.” Rachel has made an online friend in a support group for people with unfaithful spouses. As Chase calls it: irony. Insisting that Rachel’s friendship and support from a man she has never met (and most likely won’t) is the moral equivalent of having an affair, Taub wants her to stop in the same way she has insisted he not have dalliances. It’s not quite the same, she argues, refusing to end the relationship. But is she right? Should Taub trust her that this is not and emotional love affair? Or should she trust that Taub has ended his straying for good?

“I thought she’d forgive me…all those hurt feelings never went away.” But it’s not about him; it’s about her—and the demands of self-respect: faith in yourself. House of course uses Taub’s declaration to understand his patient through a different lens by making Silva’s dilemma about the daughter and not about Silva. But it could be equally applied to House’s argument with Cuddy. It’s not about his lie; it’s about her: what she needs and wants.

But when you have two people each believing so much in their own position, you end up with an intransigent battle. No one will budge until someone takes a risk that they might be wrong. Faith isn’t a winnable argument, House finally realizes as he is the first to blink.

“I was an idiot,” he confesses to Cuddy. He tells her that at some point he has to try to work through his natural cynicism and his trust issues and “take a leap of faith” that he can be honest with her without destroying what they have. “I’m sorry.” But he follows this up with a considered promise: “I’ll never lie to you again.” Now, we all know it’s absurd to think House will “never” lie to Cuddy again. Even Cuddy must know that. And when House tells Wilson that he lied to Cuddy to end the argument, Wilson is happy that he did.

But what is the lie? House never says. Is he lying when he promises to try overcoming his cynicism and trust issues? Or is he lying only about the final promise (and in my opinion an unnecessary promise)? I think he is being completely sincere all the way up to the moment he promises he’ll never again lie to her. On the other hand, House’s entire worldview is being challenged. “Everybody lies.” “People don’t change.”

House’s trust issues probably go back to his childhood, reinforced by his relationship with Cuddy. If everybody lies, then trust is a fairy tale. House is absolved from honesty and trust if it’s normative behavior. “It’s time for me to take a leap of faith,” House promises. And for him, it’s a leap across a canyon taken with a disabled right thigh. It’s a long shot. But he’s willing to try, even if the first step is taken with a lie.

Completely shallow notes: Hugh Laurie is delicious as House in a tux being James Bond in a perfect impression. (And Robert Sean Leonard is hysterically proving once again how hopeless Wilson is with accents.) I also loved that Cuddy immediately knows what House is up to when he dresses for the rehearsal dinner in Wilson-esque attire. She doesn’t like this faux-House; it’s not him. To me, it’s a signal that, as much as she wants his apology for his “Office Politics” lie, she really doesn’t want House to change.

House, M.D. is on hiatus until mid January. I will continue filing House-related stories during the hiatus, including my exclusive interview with House’s newest cast member Amber Tamblyn. I spoke with her by phone yesterday and I should have the interview up early next week. 

For those of you in the Detroit area, I will be appearing on the Detroit FOX affiliate’s morning show December 13 to talk all things House. And if you’re in the Chicago area, stop by and say “hi” at Something’s Brewing in Grayslake on December 2 during lunch, where I’m doing a book signing. 

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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