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(Warning: spoilers for the episode that aired Feb. 14)

Wow. This qualifies as the least newsy newsflash ever, but that House is one messed up dude. And … eew. This week’s episode demonstrates why I sometimes question my squeamish self’s sanity for being attracted to medical shows. Maggots covering a burn patient’s body? I guess I didn’t really need to eat or sleep anyway.

I may not be the only one requiring a psych consult, as House does a good impersonation of a crazy man in “Distractions” while still, irrationally, appearing almost rational. Of course if you need a live subject for an unethical test to prove your medical school nemesis wrong, you have no choice but to experiment on yourself. Of course if you need to induce a migraine, you should take nitroglycerin. Then when you need to get rid of the migraine – because oh, yeah, the patient of the week needs some attention – of course you should take LSD to cure it and then anti-depressants to counteract the LSD. It all makes sense. If you squint.

The med school nemesis is Dr. Weber (Dan Butler, Frasier), whose questionable migraine prevention breakthrough House is determined to prove wrong. House has been academically stalking the man for 20 years in hopes of finding a way to retaliate for being ratted out when House tried to cheat off him on a test. So he gives Weber’s miracle medication to our old friend Coma Guy, then gives him a migraine, proving, at least in House’s mind, that the drug is a failure.

His master plan is to forge an invitation from Cuddy for Weber to present a lecture on the new drug, while House sits in the back in a monster-truck lover’s disguise and discredits his research. He’s only temporarily foiled by the claim that since Coma Guy’s brain is not normal, House’s little experiment means nothing. Ignoring Wilson’s pleas to get a regular hobby – maybe a spot of bowling in place of obsession – House takes the drug himself, then successfully induces a migraine. It’s not quite scientifically solid proof, but it’s enough to convince the pharmaceutical company to back out of the deal. Though I could argue that House’s brain is not exactly normal, either. As Wilson says: “Get a hooker. Anything.”

Foreman is amusingly pragmatic about having to treat his boss for this self-inflicted misery – just another day on the job – while he, Cameron, and Chase go about the business of trying to help the patient of the week. They do have help from the astute if pained mutterings of House, curled under the conference room table. Wilson provides House with all the sympathy he deserves (which is to say, none at all) and interprets House’s actions for us: “You get distracted by pain.” And after driving away the love of his life, House needs distraction.

The neglected patient is Adam, a 16-year-old boy who was badly burned in an ATV accident … which may have been the show’s first real stunt that didn’t involve Hugh Laurie taking a punch. Though House seems to take cases a little more readily these days, burns are still not enough to bring the master diagnostician to the case, so Adam also has unexplained heart symptoms and blood test results.

Because of his injuries, the team is unable to perform the usual tests, including their favourite MRI, and must resort to some old-fashioned and creative procedures. House yet again proves he’ll do anything to get the truth from a patient, waking Adam from his induced coma to question him about his pre-accident symptoms as the boy screams in agony. But it’s all justified, at least in House’s mind, because Adam gives House the information he needs. From the clue that Adam wet himself before the accident, House pieces together the truth that the boy had been trying to quit smoking, took a cessation medication that also acts as an anti-depressant, and suffered from the rare complication of too much serotonin, causing seizures and a bizarrely orgasmic response to pain.

After House takes a shower to shake off the headache, Cameron finds him in the locker room dressed only in a towel. Under ordinary circumstances, that might be the Best Valentine’s Day Present Ever for the pining girl, but instead she’s angry to realize he’s high and “seeing” music (but … cool. There’s some cool direction by Dan Attias to mirror House’s migrane and altered consciousness, too.) She’s later equally puzzled to find him quickly recovered. We’re not shown the drug-taking, but House not-admits to Cuddy that, hypothetically, one might take LSD to help with a migraine, and then one could conceivably take anti-depressants to balance out the LSD.

He also reveals a new slice of House philosophy to explain the LSD/anti-depressant effect, as well as the eye-for-an-eye revenge on Weber: karma.

House: The universe always settles the score.
Cuddy: Does it?
House: No. But it should.

Lawrence Kaplow, who just won a Writers Guild Award for the “Autopsy” episode, wrote this one too. For those with good memories, it’s the one he was in the process of writing (and referred to as “Happiness”) in an October interview, where he says: “House does some pretty outlandish things in this episode, and it raises the question: is this only about addiction or is he self-destructive? Does he have some sort of death wish? What does House want in the end?” “Distractions” points to self-destruction as much as I thought “Autopsy” did, where House’s answer to seizing the day is to hop a motorcycle with a crazed look in his eye.

Maybe the universe really is about balance, and the patient with an excess of the pleasure hormone contrasts with the title character with a dearth of it. House’s heartbreak isn’t in the spotlight here, but it is in the shadows of everything he does. According to Wilson, House’s instinct is to distract himself from his emotional pain with physical pain. But pleasure is the opposite of pain. So the episode ends with House’s willfully depressing pursuit of pleasure as a distraction. Fortifying himself with a drink, steeling himself to answer the door, in the final scenes House invites a call girl into his apartment. Unlike his constant hooker jokes, there’s nothing funny or puerile about it. It’s a sad ending for a sad man.

Because of a supersized American Idol, next week’s House airs on Monday (Feb. 20) at 8.

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(Cross posted to Blogcritics)