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House is a show mostly trapped in the confines of the hospital set. Sure, we get teasers of patients in their natural habitats, and for a special treat, our core cast might actually have lives outside the workplace. But apart from the odd seizure, CGI, or punch, the action of the show is usually either cerebral or emotional, taking place in the minds, hearts, and mouths of the characters.

“Who’s Your Daddy?” is a perfect example of how Hugh Laurie and the producers and directors take the inner workings of House – his thoughts and his pain – and make them kinetic. Forget that damn ball, the white board, or the twirling cane, which are the usual stand-ins for his thought process made visible. This episode it’s House himself who is the body in motion.

It opens with the doctor pacing furiously, painfully, in his apartment, face contorted, finally clamoring up a step ladder to his previously unknown secret stash of morphine – only to be stopped by his “one thing,” the thing the drugs allow him to do: his job. Cuddy leaves him a message with the prospect of a juicy case, and he regretfully puts the syringe down.

The case is a teenager named Leona, raised by a drug-addicted mother and left homeless and motherless by Hurricane Katrina. Her newly discovered father is House’s old … let’s say friend … Dylan Crandall (D.B. Sweeney, who has the perfect hangdog face for the role), who is the first and, I imagine, last person on the show to call House “G-Man.” “I thought I’d met all your friend,” Cuddy tells House, hilariously stressing the singular.

The credulous, sad-sack Crandall seems an unlikely companion for House, but he explains it to Wilson: “We were 20 years old. He had a car. If he’d been a woman, I would have married him.” He also explains his sense of obligation to the man: House stole his girlfriend. Seems our warped hero not only holds a grudge forever, as with his classmate in “Distractions,” but he also honours a debt with equal longevity.

Flying home with Crandall, Leona suffered a hallucination the team believes was caused by a damaged heart muscle, but which wasn’t cured when the heart damage was. House, shockingly, thinks his patient is lying to Crandall, who won’t let him perform a paternity test to prove her claim. When Wilson expresses surprise that House didn’t do it anyway, he replies: “I said I wouldn’t.” “So either you lied, or he has pictures of you being nice,” counters Wilson. He believes House is lying about the paternity test and that the emotional suppression is causing his leg to hurt … except we know the leg was hurting before the case.

When each diagnosis seems to be a bust, instead of staying static at the white board, the aching House paces in and out of the conference room, striding down the hall to think, popping his head in when he’s got an idea or wants to ridicule one of his team’s. Or, he circles the nurses’ desk as he circles in on his diagnostic epiphany. At least walking is a healthier distraction than inducing migraines.

In order to test the theory that the girl has an autoimmune disease triggered by pain, House gets to test his theory that she’s lying by torturing her – one of his favourite reasons to visit a patient. “Diagnostically, she needed to be hurt,” he tells his shocked minions. “I wanted to hurt her. It was win-win.”

Tying in with House’s well-established love of music, Leona’s grandfather is a famous musician, Jesse Baker, of whom House once said he’d give up his own right hand to have the other man’s left. One of the keys to the case comes when House listens to a recording of Baker performing and then launching into a seemingly drunken diatribe, because House believes he had been playing too well to have been high at the time.

Foreman: “Unless you can tell me Miles Davis couldn’t play stoned …”
House: “Played better when he wasn’t. I think. I mean, no one knows for sure.”

As with last season’s “DNR,” from which I poached the “one thing” quote, House’s medical ability is here juxtaposed with artistic talent, this time more subtly. Presumably the reason House put down the syringe is that he can’t practice medicine as well when he’s high, either. At least, not too high. Ingrid the gorgeous masseuse from “Detox” is back to help alleviate some of House’s leg pain, and her presence is a reminder of his explanation of his Vicodin dependence in that episode: “They let me do my job. And they take away my pain.”

Adding the grandfather’s symptoms to Leona’s liver failure and hallucinations, they have a diagnosis of hemochromatosis, leading to too much iron, and treat her for that.

Mystified by how their deductions have been correct along the way and yet her lungs are failing, House forces the team to walk through the diagnosis and treatments again. “Is it just me, or have we discovered a flaw in the scientific method?” he grouses. What’s missing is, again shockingly, that Leona lied: she hadn’t been living in a homeless shelter, but in the recording studio, where she was infected with a fungus that was destroying her lungs.

House’s last contact with Leona is to tell her that he ran a paternity test against Crandall’s wishes, and that her lie is actually true – he is her father. It’s unfortunate Leona didn’t have more opportunity to display a personality throughout the episode, since the impact of the nice (or was it?) gesture is lessened a bit by the scene coming between House and the fairly formless girl.

Our last contact with House is to see that he lied, and to see him on his apartment couch staring at the evidence of his lie – the negative paternity test – with an empty syringe next to him. Crandall so badly wanted her to be his daughter that House paid his debt to him with that lie. This from the man who spent the episode telling Cuddy that “genes matter, who you are matters.”

Without ever leaving the hospital, we learn something significant about Cuddy’s life outside it – she has few people to turn to. In “Who’s Your Daddy?” she goes to House for advice in selecting a genetically suitable sperm donor, and he’s the one she asks to give her the required twice-a-day injections for in vitro fertilization. She, he, and we also learn how deeply she trusts him, and, perhaps, likes him. He tries to persuade her not to create a designer loser baby, not to go with an anonymous donor based only on genetics rather than personality.

House: You want someone you can trust.
Cuddy: Someone like you?
House: Someone you like.

I’m still ambivalent about the Cuddy-wants-a-baby-possibly-with-House storyline (I’m using the less common “oh dear god, please no” definition of “ambivalent”), but they are just so fun together, and there was even sweetness between them here. And I’m not opposed to House and Cuddy’s ongoing flirtation (this would be the “oh please, give us more and let that be the end-game of the show way, way in the future” definition of “not opposed”), particularly when it’s manifested in her strategically opening drawers into his, er, lap, and him staring appreciatively at her ass while insulting her.

House’s clinic patient this episode is the cutest, giggliest little boy who makes the most adorably random sneeze in the middle of the scene. As with the girl obsessed with finding Nemo/marching the penguin of a couple of episodes ago, all the way back to the early episodes of the first season such as “Maternity,” when House says “people don’t bug me until they get teeth,” and “The Socratic Method,” when House keeps calling the son of a patient a “nice kid,” he proves he can be surprisingly good with children. But c’mon Cuddy, remember, those kids grow up to be teenagers like Leona, and adults like, well, you.

Instead of taking my advice about House’s paternal potential, toward the end of the episode, Cuddy arrives at his office, scattered and hopeful, to thank him for the IVF injections.

House: You came all the way up here just to tell me that?
Cuddy: No. (She leaves the office)

Hmm. So far, I’m amused and intrigued. But they really can’t be going there, can they?

The season finale airs next Tuesday, May 23, at 9 p.m. I hate to raise expectations based solely on the credits, but it was written and directed by Mr. “Three Stories,” Emmy-winning creator David Shore, so my own expectations are not unraised.