House Watch: Score One for the Team

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Finally. Last night we got Team members Chase and Taub back on House M.D., and the show gathered a momentum that had been absent in the first few episodes of the season. SPOILER ALERT: If you didn’t watch “The Confession” last night, make yourself a Martini and settle in before reading on.

Patient this week is a purportedly great guy, Bob Harris, from a small town called Cedarville. He coaches little league and owns the only gas-station in town. But after he wins a community-service award at a local festival, Harris—a married man—takes the local pageant queen to a motel and has sex with her on the floor. He collapses while on top of her—a result of ventricular fibrillation, we later learn.

Tonight we got the Massive Attack opener back, and the title credits confirmed that Jesse Spencer (Chase) and Peter Jacobson (Taub) are back. Foreman tries to recruit them early on as spies, but they seem more loyal to their old boss than to their old colleague.

Thanks to his earnings from the (insider) stock trade he made last week after saving the CEO, House has his conference room back, although the old galley area is gone, as is the white board. Still, the first DDX begins in that famous space, and when Park meets Taub, she offers the first funny line of the night: “You’re a lot taller than I thought you’d be.”

House orders an exercise test on Harris so that he might go into v-fib again. Park points out that this may cause cardiac arrest, but of course that’s exactly what House wants, because a new arrest will make it easier to find what set off the first collapse.

The House-Wilson side plot this week is way too short, but it’s more than we’ve been getting. Wilson tries to ignore House’s banging on his office door, but House is relentless. When Wilson finally opens the door, we see that he has turned off his lights and seems unwell. He says he has a migraine, but it turns out he’s doing something House would hate: providing a favor for a colleague—in this case, taking care of Taub’s two new babies. I’m not sure how the rest of you feel, but I found the entire Taub story line about whether he actually fathered the babies to be a bit boring. It was a nice touch that the episode ended without giving the answer—that would be too easy for the show—but I didn’t really care about the stakes to begin with. Yes, House had gotten many in the hospital to beton the paternity question, and yet Taub never gave in to House’s taunting. He shredded the paternity results rather than reading them. I suppose that was the point of the Taub narrative this week: to show that the old Team members know how to keep him from playing games … Actually, the more I write about it, the more I like it.

Anyway, the exercise test leads not to cardiac arrest but a seizure, which may or may not be caused by another v-fib. At a DDX, House settles on a diagnosis of photic epilepsy, meaning the seizure would have been triggered by flickering light.

Meantime, Foreman asks Wilson why House is being so well-behaved, even keeping his clinic hours. Wilson says Cuddy used to ask him the same kinds of questions, which in the end turned out disastrously. “You have a problem with House; deal with it,” says Wilson. “Or find someone else who can.”

An EEG test under flickering lights proves that photic epilepsy is wrong, so House moves on to Park’s offering from the DDX: pheochromocytoma, a tumor in the adrenal gland. He orders a complicated set of tests to confirm, but Taub objects that he needs to care for his babies. House says Chase and Adams can do the tests, but he says Taub has to take Park to the motel where Patient hooked up with Miss Cedarville to check for any environmental toxins that Harris could have picked up.

As Adams and Chase do the tests, Chase reveals that he merely “took a vacation” when House was in prison because he knew that when House returned, he would get his job back. I’m betting we will learn a more complicated story about Chase’s time off in future episodes.

Pheo turns out to be another wrong diagnosis. In the next DDX, Park reveals the results of the environmental tests from the motel: a massage bed there has tested positive for semen, vaginal secretions, saliva, and fecal matter—both human and non-human. The bathroom also tested positive for five different types of pathogenic bacteria. House says one must be Fusobacterium, which can cause a bulge in the neck that House noticed. The diagnosis: Lemierre’s Syndrome, an infectious disease that Fusobacterium can cause when it moves into the jugular vein. House orders antibiotics and removal of the Lemierre’s clot.

As Adams and Chase operate on Harris, they find no clot but, rather, lymphoma. They get a biopsy while his neck is open, but just then he shows jaundice in his eyes, meaning his liver may be failing.

The biopsy turns out clean, and in another DDX, House orders broad-spectrum antibiotics. Adams points out that the antibiotics will “fry what’s left of his liver. The cure will kill him.” But Chase says they can get him a liver transplant first and then treat with the antibiotics—just the sort of highly irresponsible, barely supportable treatment House likes.

Trouble is, the transplant list is long. Adams explains to the wife that another option is a partial liver transplant. Adams explains that it’s major surgery that will involve both risk of death and at least three months of convalescence for the donor.

Despite those downsides, more than a dozen people from Cedarville show up to offer parts of their own livers for Harris. When they do, Harris tells them all that he not only cheated on his wife but that he’s been cheating many of his neighbors on repairs at the gas station. “I’ve been ripping you all off for years,” he says. Only two townspeople stay after the admissions, and neither is a match for a liver donation.

House has had a new bar built for himself in the conference room, and over a Martini, he orders the Team to cut out the infected part of Harris’ liver and then, if enough is left to keep him alive, treat him with the antibiotics. Adams and Chase do a late-night CT scan of Harris’ liver to find the infected part, but to their astonishment, they see that the liver is actually healing itself. House thinks this means Harris was having an allergic reaction that’s finally clearing up. Maybe he was allergic to something Miss Cedarville was wearing? Adams and Chase examine her to try to find out. Meanwhile, Park and Taub examine Harris, whose skin has a strong reaction to a wheat-allergy swab but whose blood cells show no signs of the allergy. Still, the Team believes he must have some kind of allergy, so they start him on steroids. Big mistake: Patient gets a lot worse when an excruciating new symptom appears—his skin starts to peel off in large pieces.

Park breaks the silence at the next DDX by asking a question that could have been asked in dozens of previous differentials on House M.D.: “Is everyone trying to think of an answer, or is everyone afraid to say what the answer is?”

“I take it you’re in the latter category,” says House, and he’s right: Park thinks Harris has Stevens-Johnson syndrome, a skin reaction to medication and infection that, in Harris’ case, would be so advanced after the steroids that he will likely die. “Case closed,” says House. “You should go home and get some sleep.”

But Chase stays with Harris, who says he has another confession: he murdered four or five people. Chase finds this confession weird, and he diagnoses a neurological condition: an aneurysm that, as it grows larger, causes Harris to confess to more and more. He even admits to stealing one of Chase’s shoes, which would have been impossible considering his physical incapacitation. Park points out that a neurological condition wouldn’t cause Harris’ skin to fall off; House then concludes the aneurysm can’t be the diagnosis but just another symptom. Add all the symptoms together, and he comes up with the Final Diagnosis: Kawasaki disease, which involves inflamed blood vessels. Taub points out that the disease almost always presents in Asian children, but House reasons that Harris got it from the motel’s carpet cleaner when he was having sex with Miss Cedarville.

The treatment is fairly simple, and after Harris improves, he wife shows up. She knows that he’s been confessing to crimes he never committed, but now—like so many Patients before—lies: he tells her he has never cheated on her.

The episode ends with House unveiling a new toy he’s bought: an automatic door that, with a click, will slide up from the conference room to reveal Wilson’s office. Which is good news for the show, since the House-Wilson scenes are often the best parts.

My diagnosis: a B-minus episode. Having Chase and Taub back was like seeing old friends again, but I still don’t find Foreman convincing as dean of medicine. Lisa Edelstein’s departure has hurt the show tremendously, but at least last night it started to get its footing again.

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