False advertising. I see a title like “Son of Coma Guy,” I see John Larroquette is guest starring, naturally I think the always-entertaining Night Court alumnus is going to be the son of House’s recurring Coma Guy. Instead, the title is blatant false advertising. This episode, as House would be the first (and probably only) person to point out, is really “Son of Vegetative State Guy.” (Did you know there was a difference between a coma and a vegetative state? All these years of watching medical shows and no one told me.)

“Son of Coma Guy” does open with a special treat for fans of Coma Guy, though – a whole roomful of coma guys and coma girls. Sorry, vegetative state guys and vegetative state girls. Is it sick and wrong to think a roomful of coma patients is funny? And is it bad to be sick and wrong?

In any case, Larroquette is one of the roomful, and House is multitasking by not only enjoying a Reuben in his vegetative company, but enjoying a lecture from Wilson on the importance of not forging a narcotic script on your only friend’s prescription pad, and sitting in wait for Vegetative State Guy’s son Kyle, who had exhibited suspicious symptoms last time he visited.

House performs a cool trick of turning the lights on and off and – because, no, that wasn’t the cool part – seeming to disappear, since we momentarily get Kyle’s addled point of view from frequent House director Dan Attias. The doctor’s mission is accomplished when Kyle has a seizure and falls into a coma. Like father, like son. “God I love this family!” House exclaims.

Except Gabe’s coma was a result of him racing into their burning house in a failed attempt to save his wife after first saving his son, and except for the not-waking-up thing, he’s pretty healthy. Kyle’s pre-existing symptoms, followed by the House-induced coma, is followed by liver and kidney and heart failure.

While Kyle is the patient of the week, it’s his dad who steals the show, and this John Larroquette-Hugh Laurie show is worth more than the price of admission. In a plot borrowed – with credit – from Awakenings, House gives Gabe L-Dopa to revive him from his 10-year slumber in order to quiz the man, since he suspects a genetic link in his alone-in-the-world son’s condition. With this amount of fun involved, he doesn’t even send Cameron in to get the family history. Before Cuddy can stop him, he miraculously awakens Gabe, who at first makes House seem sentimental by asking for a steak before asking after his son.

Wilson: “Rumour in the cafeteria said caustic guy was waking up coma guy.”

House: “Technically vegetative state guy was woken by … yeah, caustic guy.”

I’m a little annoyed with episode writer Doris Egan, who wrote the fantastic “Failure to Communicate” and “House vs. God” as well. I wasn’t going to take notes while watching “Son of Coma Guy,” since I prefer watching like a normal person, plus writing a review based on notes always makes it longer and harder to write, and I wanted to take the lazy route tonight. But this is one of those episodes where paragraphs of character revelation come at us in beautifully expressed – and, of course, delivered – dialogue. So I was forced to grab a pen and forgo some extra sleep again.

Anyway, that tangential whine was brought to you partly by this next exchange between Wilson and House. House explains that the “simple” explanation of Gabe’s indifference is that the father doesn’t love his son, while Wilson says that just because House’s father’s feelings were conditional doesn’t mean that’s the most likely answer.

Wilson: We have an evolutionary incentive to sacrifice for our offspring, our tribe, our friends – keep them safe.

House: Except for all the people who don’t. … Everything is conditional. We just can’t always anticipate the conditions.

And there it is, the characteristically rich dialogue that has the doctors talking about the patients but also about themselves and each other. Wilson is no stranger to sacrifices keeping a friend safe. “Son of Coma Guy” picks up a thread we largely left in last season’s “Daddy’s Boy,” when we discovered that House feels he’s a disappointment to his father. And when I wrote short reviews and was careful not to spoil any plot points. I got sleep then. But I have more fun now. Anyway, the key quotes from that episode, which describe House’s daddy issues as far as we know them, were:

House: My dad’s just like you [Cameron]. Not the caring ’til your eyes pop out part, just the insane moral compass that won’t let you lie to anybody about anything. It’s a great quality for boy scouts and police witnesses. Crappy quality for a dad.

Later – Cameron to Wilson: So his dad tells the truth. He can’t handle that?

Wilson: He hates being a disappointment.

Cameron: He’s a doctor. World famous. How disappointed can they be?

Wilson: You know what I figure is worse than watching your son become crippled? Watching him be miserable.

What we don’t know is the whys under all that explanation. House’s issues obviously go deeper and earlier than his disability. And there’s that puzzling reference to a lie, which could be explained by anything or nothing we know so far. “Son of Coma Guy” takes our understanding a step further, and the mystery of House’s twisted and poignant psychology a step further, too.

Gabe decides that with his one bonus day of life – just like in Awakenings, his newly uncomatose state is temporary – he wants to hang with House and Wilson in Atlantic City. Well, to be more accurate, he wants a particular sandwich from a particular place in Atlantic City. And since he has no money or car, House offers Wilson’s in exchange for the opportunity to quiz him about his family’s medical history. So just like in Egan’s “Failure to Communicate,” we get House on a road trip. We also get a blatant and funny Ip Od product placement.

Gabe, however, adds a game to this quid pro quo exchange – for every question of House’s, House has to answer a question of Gabe’s. Why? Because Gabe is a power-hungry control freak, and “the only power I have left is the power to annoy you.” Hey, that’s House’s power!

Gabe knows how to go for the jugular, asking only intrusive personal questions. And whatever ethical lapses House commits, he’s oddly noble, so he holds up his end of the bargain. Yes, he loved someone. He met her when she shot him. At paintball. Lawyers versus doctors. Has he loved anyone else? Nope, won’t go there.

Meanwhile, creepy cop Tritter (creepily effective guest star David Morse) quizzes House’s team in brief scenes that offer some thematic similarities to the House discussions they transition from. Everything’s conditional? Cut to Tritter asking Cameron how House has earned her loyalty. Gabe craves power? Tritter tells Chase “medicine attracts people who are attracted to power” and refuses to believe House asks for rather than demands Vicodin prescriptions from him. House is an ass? Foreman agrees House is an ass. OK, that scene could have been placed anywhere. Tritter also says “everybody lies” to explain his interest in the case. That sounds familiar. Maybe Tritter and House aren’t so unalike?

The plot motivation for Gabe and House’s fun and revealing Q&A is to diagnose the declining Kyle. House first thinks he has found the answer in mercury poisoning, then when that fails to hold up, goes back to a genetic link, finally landing on something called ragged-red fibre. The medical details felt largely irrelevant though, with the character motivation so much more interesting.

Wilson gets in on the House interrogation, then answers his own question – why his prescription pad for the forgery? Why not Cameron’s, or Chase’s, or Foreman’s?

Wilson: I associate with you through choice, and any relationship that involves choice, you have to see how far you can push before it breaks. … And one day our friendship will break, and that’ll just prove your theory that relationships are conditional and you don’t need human connection, or deserve it, or whatever goes on in that rat maze of your brain.

House (to Gabe): Sorry. If I’d known he was going to be this annoying, I would have stolen Dr. Cameron’s pad and Dr. Foreman’s car. At least she appreciates my brooding melancholy.

As Wilson fills the role of food wrangler, trying desperately to get Gabe his sandwich, House offers up his privacy and dignity to Gabe in order to get the final answers he needs. The question Gabe chooses to ask is why did House become a doctor? He refuses the smart-aleck response, and rephrases: “Why work with people when you obviously hate people?”

Oh, good question, says Wilson’s face. Slowly, reluctantly, House relates this story about living in Japan with his military father, and taking his friend to the hospital after an accident:

“My friend came down with an infection and the doctors didn’t know what to do, so they brought in the janitor. He was a doctor. And a burakumin – one of Japan’s untouchables. His ancestors had been slaughterers, gravediggers, and this guy knew that he wasn’t accepted by the staff. He didn’t even try. He didn’t dress well. He didn’t pretend to be one of them. The people around that place didn’t think that he had anything they wanted. Except when they needed him, because he was right, which meant that nothing else mattered. And they had to listen to him.”

This is obviously the first time Wilson’s heard this story. Maybe the first time House has told the story. To him, it seems, dignity means never admitting vulnerability, keeping his raw emotions in a vegetative state. Yet that story reveals a lot about his vulnerabilities and emotions while raising even more questions about this man’s rat maze brain. He’s brash, he’s egotistical, he’s misanthropic, and he desperately clings to his medical gift because it’s his pass into a world where he doesn’t fit, can’t fit.

It’s a trade of poignant story for poignant story. Hearing Gabe’s story of the fire that killed his wife gives House the clue he needs. While he and Wilson have assumed that Gabe hates his son, or is ashamed of him, or now that they know the boy accidentally started the fire, blames him. But Gabe has a different reason for fleeing from his dying son. “I failed to keep my family safe. I couldn’t save my wife. Now you want me to stick around and watch as I fail to save my son?”

Though the compiled clues of Kyle’s genetic klutziness lead House to the final diagnosis, it’s too late to save Kyle’s heart. Since the young man is a serious alcoholic, a heart transplant is out of the question.

Gabe, whose reflexes have already started to decline, has an answer to that question too. He wants to donate his heart. The one that’s still beating inside his not-dying but soon-to-be-comatose chest. After a brief and not very spirited attempt to talk him out of it – I know we only have an hour here, but geez, this is a pretty monumental decision – House orders Wilson out of the room: “Maybe I don’t want to push this ’til it breaks.” And then he advises Gabe on slow, painful suicide methods that are most likely to result in a viable heart as Wilson goes to the casino to establish an alibi for House.

It’s heartbreaking – no pun intended – and House feels it. This isn’t a case of House breaking all the rules to save a patient. It’s about breaking all the rules to save a patient, fulfilling a man’s desire to protect his son, and letting himself be part of an action that proves that sacrifice and love aren’t always conditional. In one of his darkest, most ethically compromised moments, House is actually at his most optimistic.

Gabe struggles to come up with a final message for the son he hasn’t seen in 10 years. “Tell him – I don’t know what to tell him.” Personally, I think the heart speaks volumes.

Gabe asks a final question of House – what would House want his father to say to him? After warning Gabe that his answer won’t help, House says: “I’d want him to say ‘You were right. You did the right thing.'” Another mystery. Right about what? What thing? It’s been pretty much exactly a year since “Daddy’s Boy,” so I suspect even vague answers won’t be coming any time soon. And how sad is it that House wants to be right more than he wants to be loved?

I don’t think House will be out of legal trouble any time soon, either. House pays Wilson back with a little armchair psychology of his own, prodding the oncologist about why he helped Gabe get his Sandwich of Avoidance. “I don’t think my enabling is anything you should be complaining about,” Wilson admonishes, before discovering his enabling has caused his bank accounts to be frozen as part of a police investigation. House points out they can’t keep his money forever.

“No, they can keep it until I agree to help send you to prison for 10 years.” Pause. “You’re getting dinner.”