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“All In” begins with the coolest class field trip inside a model of a giant heart, with effects to rival, say, a prime-time medical show. My class once went on a field trip to make candles. But I can take consolation in the fact that the heart lost its cool factor as soon as the pregnant teacher – our pre-credits decoy – shrieks in pain, and the adorable little boy with the big blue eyes asking her where the bathroom is ends up with seeping bloody diarrhea.

But when we first see our main cast, all thoughts of disgusting bodily fluids are banished, to be replaced with thoughts of shiny, pretty clothes. They are attending the hospital’s charity poker tournament, a wonderful excuse for the costume designers to spread their wings, and for us to revel in the photogenic cast rocking some formal wear. House in an unrumpled tux, complete with fancy cane, is a sight I thought would only be seen in a dream sequence, but I have to say, Cameron and Cuddy looked equally fabulous.

Would it be bad if House pretended it were a soap opera, and the characters walked around in formal wear for no apparent reason? Or if House-and-therefore-Hugh-Laurie could play the piano every episode for no apparent reason? The show is a prestigious Peabody Award winner now, though, so I suppose that might be unseemly. Oh well, I enjoyed it while I could.

I sadly enjoyed the shallow visual and aural spectacle more than the rest of the episode, which was light on both the laughs and the character development this week. I know it seems unfair to say about a medical show, but it relied too much on the medical mystery, interesting though it was. And, I’d like to assume, credible, since this episode was written by the show’s actual doctor writer, David Foster.

The kid, Ian – who House refers to as “The Kid” throughout the episode, of course, causing me to wrack my brain to remember the character’s name – is Cuddy’s patient, but Cuddy listens to his symptoms while at the poker table with Wilson and House and decides it’s gastroenteritis, a simple stomach bug. Something piques House’s interest, though, so he sneaks off to check on The Kid, who he finds is having trouble coordinating his muscles, too.

House rounds up his reluctant team for help – most notably an on-the-make Chase, whose attempt to impress a woman at the party with tales of shark punching is interrupted by House inquiring about his anal fissure. The reason for House’s interest in the case is yet another layer of House obsession, but one that doesn’t really add to what we know about the character. Twelve years before, he lost an elderly patient with the same symptoms as The Kid, and has been trying to solve the case on others he’s encountered with those symptoms. We know this old case means a lot to House because he actually knows the dead patient’s name: Esther. Or Ester, if you believe the patient chart. But he almost knows her name, and that’s significant enough for House.

Though the team-against-House arguments get a little tiresome sometimes when we know, and they should know, that he only ends up with extremely oddball cases, and that his crazy ideas are not actually crazy, this time Chase gives us a reason to be on the team’s side for once: House in the past has subjected patients with a stomach bug to invasive tests on his quest for closure. Still, the tension between whether House is right or his doubters are right is never quite enough to sustain an episode.

Because of Esther/Ester, House knows the progression of symptoms The Kid will face, a progression that quickly leads to death. He also knows he needs to keep Cuddy away so he can have time to solve the mystery before the little boy faces the same fate as the old woman. He phones Wilson to get his help in distracting Cuddy, but both Wilson and I were fooled by the real nature of his plan – he’s actually “helping” Wilson to lose, so Cuddy will stay in the game.

The team, and later Wilson and Cuddy, worry that House’s obsession with his 12-year-old lost case is affecting his decision making with Ian, but also that if he loses again, the obsession will only intensify. He’d even started taking out his frustrations on the poor, innocent white board. The difficult part for me was that the emotional attachment House has to the case are rooted in a dead patient we’ve never met, not for the little boy in front of him. And his obsession isn’t personal, it’s professional, so the emotional stakes aren’t high enough for me to agree with Wilson’s assessment that “obsession is dangerous.”

Except maybe it is dangerous for The Kid, who gets shocked endlessly when the heart biopsy House subjects him to causes him to go into cardiac arrest. I don’t doubt that House would be tormented if the boy died, or was permanently brain damaged by the resulting oxygen deprivation he caused, but I only saw the single-minded determination to solve a previously unsolvable puzzle. And we’ve seen that before, many times.

There were flashes of fun in “All In,” including most of the poker scenes, but the attempt to tie in Wilson’s poker prowess with House’s final medical deduction didn’t work for me. Maybe I just don’t fully understand poker (a good bet, since I last played on our Intellivision set when I was a kid), but the connection just wasn’t strong enough for me between Wilson’s hidden aces and the initial and also final diagnosis of Ernheim-Chester disease, which hadn’t yet reached the intestines where they originally tested. But then it’s also a good bet that I don’t fully understand medicine, either, since I last practiced on Sam, from the Operation board game.

A new episode of House airs Tuesday, April 18 at 9 p.m. on FOX, or Global in Canada.