Finalewatch: 'House M.D.' Teardrop on the fire

Annedudek_house_s4_240_2 After last week's cliff hanger ending on House M.D., I didn't know what to expect from tonight. In the wake of giving himself a heart attack on top of pushing his cracked skull into working overtime, how much further would House go to save Amber? And how far had he already gone with her? I didn't think House could betray his best friend, but things were looking shady.

The episode used a minimum of time going through previously seen footage. I'm going to spend even less and skip it entirely, since this recap will already be a lengthy one. We begin with House and Wilson at the community hospital that is currently treating Jane Doe #2 - AKA Amber. Kidney failure has progressed into an ever increasing heart rate. That hospital can get her into surgery in a couple of hours. Their own is a mere 15 minute ride away. Wilson poses as her husband and they move her.

In the ambulance ride, Wilson still cannot wrap his head around everything that is going on and so he focuses on the one answer he thinks he might get by asking House why she was on the bus and why they were together. Unfortunately, Amber is crashing in the meantime. House is about to use the defibrillator when Wilson asks to ice her instead. He reasons that if they bring her core temperature down low enough they can induce a protective state of hypothermia, whereas if they jump start her heart it can release all sorts of free radicals that may kill her brain. The go for the non-brain-killing option, icing her and putting her on a by-pass machine to take over the job of her heart.

The team gets together for the differential, but the best they come up with outside of blood tests is to have House take the Alzheimer's medication again. As he points out, he already had a heart attack that morning and can't do anymore drugs until after lunch. The team dejectedly files out, except Taub, who hangs back to ask House if there was anything medically relevant that he was unable to disclose publicly. Which is a very politically correct way of asking what kinds of naughty he may have been doing with Amber that precipitated the event. House comments that he didn't sign up for a philanderers anonymous meeting, but when he can't answer Taub on the matter of what substances might have been ingested, Taub decides to run a tox-screen.

Kalpenn_house_s4_240_2 Meanwhile, 13 and Kutner are visiting Amber and Wilson's apartment. They are poking around, though 13 clearly doesn't want to be there. Kutner is more emotionally distanced from it all, but as we learn it is not because he is emotionally cold. His parents were killed when he was 6 years old and he learned that death was the way of the world. Which is very zen, but I am not sure I would want my doctor to have that same attitude.

House still hasn't slept and when he does attempt to shut his eyes, he finds he is not alone. He asks Amber what they did last night while she pours him a glass of sherry and straddles him, asking him if she feels familiar before whispering the word "electricity" in his ear. The dream gives him an idea - to attempt deep brain stimulation. But Cuddy immediately shoots it down on the basis that drilling holes into already cracked skull is probably not a structurally sound idea. On more than one level. On the other hand, all the tests the team have run have revealed a whole lot of absolutely nothing.

However, Kutner and 13 turned up a few interesting finds when they uncover diet pills, SSRIs and amphetamines. While I am sure there are several houses in which you will find Dexatrim, Zoloft and Adderall, those houses are not likely to contain two doctors with one doctor hiding the pills from the other in a Vitamin E bottle. House decides to take the easy test by cracking Amber's chest and poking a finger on her pulmonary artery. Whether or not they feel calcification will decide if they warm her back up for treatment. When that is the safe route, I think you are in it deep.

The team is more disturbed that House is basing tests on the notion that their assumptions may be wrong. And while I understand that seeing your bosses confidence shaken like that might be disturbing, I am still surprised at the vigor with which the team argues that he is compromising his treatment plan based on his relationship with the patient. Even more surprising is Foreman arguing that they treat first, because it's faster. How often has he argued against that? Even run tests behind House's back? Has he finally given in to becoming more like House after all? Lastly, 13 accomplishes nothing, other then desperately attempting to blend in with the carpeting. So House calls her out and tells her that she needs to get over whatever is bothering her and do her job. With no niceties or coy games to get under her skin, it's like a splash of cold water on an already tense episode.

They team suits up and is about the crack her chest when Chase notices that Amber's eyes are yellow, indicating that her liver is failing. Which means no opening her up and she stays on ice. But House is on to the more subtle mystery of his dream. He doesn't drink sherry (and really, who does?) so he's trying to figure out what it could mean. Which is when he remembers the name of the bar is Sharries. He and Wilson take a trip and the bartender (played by Fred Durst. Yup.) gives him back his motorcycle keys. House asks him if Amber seemed sick and he mentions that she sneezed before letting them know that he was too busy to analyze his girlfriend's snot. Which is particularly awkward since Wilson is there. House tries to say that she isn't his girlfriend and the ever helpful bartender shoots back that she was hot, he seemed into her and she bought him drinks, so last night she was his girlfriend. Yeah, time to go.

Wilson tries to question it but House redirects his focus and they decide to fill Amber's lungs with slurry to buy more time. I am unsure what that means exactly, but 'slurry' doesn't sound too bad. Sort of like a dessert drink. Which made the graphic overlay of dark blue sludge sliding through her esophagus and filling her brachia all the more horrifying. Meanwhile, the team suspect she may have HepB and they are about to treat her for it when House drops off to sleep to another visit, where Amber tells him it's a lame diagnosis. But it triggers more memory and House rushes the room to stop them, pointing out a rash on her lower back. They settle on Rocky Mountain Spotted Fever (what?), but Wilson wants to keep the treatment safe (because apparently he has seen the show), leading to more strife with the team.

Oliviawilde2_house_s4_240 It's only remarkable because it leads House to confront 13 with what's really bothering her. That the idea of a young, female doctor is dying - an idea that strikes a chord with her but which she has avoided by not testing herself for Huntington's. In no mood to coddle her, he tells her to deal with it or pack up her stuff and go. While this is going on, Foreman is going behind House's back to Cuddy, to tell her that he thinks House is using bad judgment and will kill Amber. Next thing we know, Cuddy and Foreman are pulling a House...on House, by treating his patient against his wishes. Only, they are not House and soon Amber's EEG is slowing, indicating the infection has spread to her brain thanks to their attempt to bring her temperature back up.

However, despite Wilson's clear fury over the matter, it has made House realize he has played it safe and it's doing her no good. Which is when Wilson brings up House's earlier idea of deep brain stimulation. Yes, he really does ask his best friend to risk his life for his girlfriend. And, though I cannot quite believe it, they all move forward with it. Chase performs the surgery, delivering volts of electricity directly into House's ventral hypothalamus. And it does release his memory.

What we learn is that House did have too much to drink. But he was alone when he did it. And when his keys were taken away, he called Wilson. Only Wilson was on call and Amber was home. Which is why she was with him. But all the pieces don't fall into place until House hears her say she's getting the flu and take some pills.

It doesn't have the same "eureka!" power as last week's necklace revelation, but it's more emotionally charged as the situation is explained, in slow and agonizing detail. Amber took amantadine for her flu, but was poisoned by it, and since it binds to proteins, dialysis won't clear it out of her system. There is nothing they can do and Amber has been killed by the cure for the common cold. It's ridiculously simple and devastatingly complex, made all the worse because she's a doctor taking it herself. This in and of itself makes the scene crushing. It gets worse when a tearful House experiences a full on seizure, which leads to cracking his skull and a brain bleed.

Robertseanleonard_house_s4_240_2 The team gets the news that there is nothing they can do to help Amber. That there never was anything they could do. Cuddy talks Wilson into weaning her off the anesthesia so she can wake up and they can say good-bye. A decision that is hard enough, much less having to get around to the actually saying good bye part. Because before they can get to that, Wilson will have to tell her that she was in an accident, that all her organs are failing and that she's going to die in just a few hours.The team each file in and don't even have to say a word to Amber before it's just she and Wilson laying in her hospital bed. Until she tells him she's tired and it's time to sleep. It's wrenching and marvelously well played by everyone.

House has a final dream. He and Amber sit on an all white bus and discuss the options of dying, being pain free, no longer being miserable and the unfairness that a bitter misogynist gets to live while love struck hopefuls are a lost cause. And how he doesn't want Wilson to hate him for not being able to save her. For being the reason she was on the bus. But Amber grins and tells him that he can't always get what he wants (nice call back), before we get to the final montage. House opens his eyes to a tearful Cuddy and Wilson, who walks away. 13's Huntington's test comes back positive, Foreman, Chase and Cameron meet for a beer, Kutner watches TV alone, Taub hugs his wife and Wilson? Wilson goes home to a relatively new but empty bed. Until he finds a note, hastily scrawled on the back of a bill:

"Sorry I'm not here. Went to pick up House. (love) A"

Ouch?

So, yeah. Not much funny tonight. But there were these:

13: It could be anything .
House: Let's go with that. Quick! Get her on panacea!

Wilson: This is exactly what I was afraid of! You went behind my behind my back! You went behind House's back!
House: Inside voices.

I am still stunned myself. I never figured they would kill off Amber, ripping Wilson down that much further, weakening one more of House's already tremulous sources of support. And how incredible were the performances tonight?  I can't quite wrap my head around it all enough to have many questions about what we might see next season, but here's what I got so far: How will this affect House and Wilson's friendship? Did Cuddy seem a little too relieved with House's awakening? What will be the long term effects of a cracked skull and brain bleed? How will 13's positive status change her character? Discuss, while I go get a fresh box of tissues.