A great episode, no question about it. We see the emotional evolution and then devolution of House. He is facing a reality where being "House" is not acceptable anymore, and where logic and knowledge do not rule the world. His fragile emotional world collapsing, he can't even resort to the world of medical challenges where he believe he has the ultimate control, because that control is just imaginary and the harsh reality is setting in. And then, just as he is about to descend back into being House of seasons 3-4, we get the most surreal and ridiculous ending. House's life is an ongoing struggle within himself, it's a cyclical lifeline. And over the last few episodes we watched him descend into one of the deepest recesses on that graph. The ending of this episode either meant that we just witnessed House reach the bottom, or that a magic hand pulled him up by his hair onto the surface. I do hope it was the former - I (and I think the majority of House audience) am not a great believer in the magic hand. So for now, it's a 9/10. But should it turn out to be the magic hand, 5/10 would be more like it.