With Bryan Singer back in the director's chair, our maverick MD is enticed by the case of a young male whose low blood pressure doesn't respond to treatment by IV fluids. What's more, the young college student is presenting with five other symptoms, amounting to a persistent cough, a rash, fever, nausea, and abdominal pains to add to low blood pressure, for which no one diagnosis will fit. In analysing with his team what could be the cause, House caustically berates Forman after slamming a heavy tome medical dictionary in front of him: ++"If you're going to list everything it is not, it might be much quicker to do it alphabetically'++ This precipitates a diagnostic 'joust' between the two characters which ultimately permits a solution to be found.
On a lighter, more uncomfortable note, this episode, if mirroring the style of 'Friends', would be entitled 'the one about sex'. The question of sex comes to the fore, as the patient and his college fiancé's strenuous sexual gymnastics open proceedings and end with the former's lack of response and apparent coma-like status. Later, Dr Chase ridicules the patient's girlfriend's concerns that she 'rode him to death', while Cameron acerbically and glibly challenges that Chase should have explored these claims more seriously. With his response of 'Have you ever taken a life?', we have the first frisson of sexual attraction between the two characters. This is also picked up by Foreman, who warns Chase of the pitfalls ahead of any relationship with a professional colleague.
In the continuing, secondary, light-hearted thread to each episode's storyline, House himself continues to seek any opportunity to distance himself from any direct clinical work and contact with patients. In this episode he brilliantly sets out to become wholly unapproachable by announcing to all the gathered patients: 'I'm Dr Gregory House; you can call me Greg. I'm one of three doctors staffing the clinic this morning. I am...the only doctor currently employed at this clinic who is forced to be here against his will...if you're particularly annoying, you may see me reach for this: this is Vicodin...i do not have a pain management problem. I have a pain problem. But, who knows. Maybe I'm wrong. Maybe, I'm too stoned to tell.' Unsurprisingly, he has no takers, and all raise their hand when he asks if they would rather be seen by the other doctors. This sub-plot also contains its own cringe-worthy brush with sexual practices when House establishes that a young male patient's discomfort at sitting down is due to his having utilised his MP3 player for sexual gratification.
Once again series creator, Shore's storyline offers significant medical intrigue. After a course of antibiotics cause the patient's blood pressure to further decrease, his lungs to fill with fluid, and his creatinine levels to rise, a seventh symptom of kidney failure is added to the list. House posits a million to one possibility that our college student has had the misfortune of suffering from a combination of two conditions simultaneously. However, his suggested treatment then leads to the patient's immune system crashing.
Omar Epps was by far the most familiar name of those actors cast to portray our trio of interns, having made memorable performances alongside Tupac Shakur in 1991's 'Juice' and in John Singleton's 'Higher Learning' four years later. His casting as Dr Eric Foreman was the second occasion he would star in a notable medical drama, having appeared in Season 3 of the 'ER' as downtrodden Dr Dennis Gant. Here Epps' character is far more assured, arguing with his colleagues' unquestioning stance towards House's arguments. This is the first episode where Foreman's confidence to challenge House's opinions comes to the fore. As he puts it: 'So is that our job? House's puppet's. He comes up with an insane idea, we get to pretend it's not?' He even borders on suggesting the other two have a 'Stockholm Syndrome' reverence for their obstreperous lead.
For those of us who love House as a flawed anti-hero, one of the best scenes surrounds Wilson's sarcastic observation at how attractive a quality is House's smugness in informing Foreman that he knew they would be in the lab trying to prove his theory wrong, as opposed to observing the patient's condition, which had visibly improved, proving him right. House retorts: 'It was either that or get my hair highlighted. Smugness is easier to maintain.'
Yet, Foreman is ultimately proved right, having been the first to quote 'Occam's Razor' that the explanation most often correct is that which requires the fewest assumptions. A simple near-miss in House picking up the wrong phial of tablets from the hospital pharmacist leads to him solving the case. As House declares, seven thousand people a year die from pharmacy screw-ups, and here it appears the patient was wrongly given gout as opposed to cough medicine.
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