House — Episode 21 (Season 6): “Help Me” [Season Finale]
The Season Finale of House, Season Six, and it summed up the season in a microcosm: moderately interesting case and uninspired medicine all sacrificed in the name of soap opera.
There has been a crane collapse in Trenton and Cuddy rushes over to lend a hand. House heads over too for reasons of his own, most of which have to do with Cuddy. They spend most of their time triaging victims (deciding who needs treatment first, and who can wait). House diagnoses one person with a skull fracture noting that she has a Glasgow Coma Score (GCS) of 11 (a “moderate” brain injury). He tells Cuddy that her patient is unlikely to survive, so not to waste resources on him. Cuddy agrees, telling the paramedics that the patient is expectant (expected to die — and he does die a short time later).
Foreman is treating the crane operator, who apparently fell asleep on the job. House finds a stash of caffeine pills in the operator’s pocket; he says he was taking them plus drinking coffee – something he doesn’t normally do — all in an attempt to stay awake. Given the fact that the operator fell asleep despite all the caffeine he was consuming, House suspects there is an underlying neurological problem. He has Foreman take the operator back to the hospital to evaluate.
Later, sitting by himself, House hears a clanging sound from deep in the rubble. He alerts the other rescuers, but they can’t find anything. Undaunted, he crawls into the rubble himself and finds Hanna, a woman whose leg is pinned by a heavy beam.
Back at the hospital, the team’s initial diagnosis of the crane operator includes vasovagal episode (a fainting spell), sick sinus syndrome (the heart’s natural pacemaker is not working correctly), or a meningioma (a tumor of the membrane that surrounds the brain). Taub believes the operator simply fell asleep on the job. House suspects a space-occupying lesion (like a hematoma, abscess, or tumor), so orders an MRI.
The paramedics cannot get an intravenous line in Hanna, so House places an intraosseous line (where IV fluids are directed into the bone marrow instead of a vein). It becomes clear that Hanna is trapped by a support beam, so Cuddy and the paramedics recommend amputating her leg or risk crush syndrome (basically, when muscle is crushed it releases a bunch of toxic substances. As long as the muscle remains trapped, these toxins are sealed off from the body, but once the crush is relieved, all the toxins come pouring into the rest of the blood stream causing kidney failure and other serious problems). Hanna will have none of it and House convinces them to give it a few more hours to remove the rubble over the beam. He promises that they will not need to cut her leg off. House wants to head back to the hospital, but Hanna has a panic attack being left alone, so he stays.
The MRI is normal, but the crane operator starts bleeding from both the nose and eye, suggesting something is wrong. Chase thinks that he has a brain infection — but he’s not showing any fever, so House favors a venous sinus thrombosis (a clot in the large veins that drain the brain) and wants the team to perform a venogram.
An attempt is made to lift the beam off Hanna’s leg. It seems to work at first, but a secondary collapse occurs and her leg is still trapped. Furthermore, she suffers a tension pneumothorax (a dangerous type of collapsed lung), which House relieves with a needle thoracostomy.
The venogram is normal, but now the operator is running a fever. The new differential includes a subarachnoid bleed or meningitis. House orders a lumbar puncture.
Cuddy tells House that it’s time to face reality: they need to amputate Hanna’s leg. House insists he can buy her more time by treating her elevated potassium with glucose and insulin. However, in the end, he agrees with Cuddy, and climbs into the rubble to tell Hanna that her leg must be amputated to free her. He tells her about his leg injury and how he wishes his leg had been cut off. She agrees to the procedure, and House performs the amputation himself, getting her free of the rubble. He climbs into the ambulance alongside Hanna and her husband for the ride back to the hospital, leaving his cane behind.
The spinal tap was normal, but now the patient is in a coma. House realizes that his symptoms (passing out, bleeding, coma) always occur at times of elevated blood pressure. From this, he deduces that the patient has an arachnoid cyst on his lower spine. He is about to order a CT scan to confirm when
Hanna starts to have trouble breathing and her blood pressure is dropping rapidly. A quick exam shows no evidence of pneumothorax (collapsed lung) or tamponade (bleeding into the sac around the heart), so he deduces that she has a pulmonary embolism (blood clot in the lung) from being trapped in the rubble for too long. He gives her Streptokinase, a thrombolytic (drug which dissolved blood clots), but when he sees no response, he realizes that she must have a large fat embolism (a clot made up of fat), which can be a complication of orthopedic surgeries such as an amputations (or caused by the trauma itself). Unfortunately, there is little that can be done for a fat embolism and Hanna dies before she can get to the hospital.
Dispirited, House returns to his apartment and grabs the Vicodin bottles he has stashed there. He is sitting on the floor, contemplating taking the medication, when Cuddy walks in and tells him that she has called it off with Lucas…
Most of tonight’s medicine was trauma medicine, and area I (thankfully) don’t practice much in. I’d like to hear what any emergency physicians, paramedics, or EMTs thought. As usual, major complaints are in red, minor complaints are in blue, and nit-picking ones in green:
Streptokinase is not routinely carried on ambulances. ( I say “routinely” only because I know there have been a few studies run on pre-hospital thrombolysis in myocardial infarctions, but they use more modern thrombolytics.)
Recent surgery is a relative contraindication to thrombolytic use (as opposed to an “absolute contraindication”, so it can be used if it is felt that the benefits outweigh the risks – but remember, we have no idea if Hanna suffered other injury from the collapse. She very well may be bleeding internally.
Thrombolytics time to work; they’re not immediate.
House didn’t cure her tension pneumothorax, he merely converted it to an open pneumothorax. A less dangerous situation to be sure, but still a collapsed lung.
High potassium is not the only toxin in crush injuries — though it is probably the main one, or at least the one of immediate concern.
Spinal arachnoid cysts present with spinal cord compression symptoms (if they have symptoms at all). Blaming one for unconsciousness, coma, and bleeding from the nose and eyes is quite a stretch. A cyst large enough to cause problems like that would have demonstrated spinal cord symptoms long before.
ABCs. They should have intubated her as soon as she had trouble in the ambulance. It may not have saved her life, but it could have bought her time. You can deliver a lot more oxygen by endotracheal tube than by face mask.
Glucose + insulin is a valid way of dropping an elevated potassium in emergency situations (though at this point, she was still trapped, so worrying about treating the hyperkalemia is premature)
I know of no hard and fast rules about how long you wait in a crush injury before amputation, other than that amputation is considered the treatment of last resort, used in immediately life threatening situations (building on the verge of collapse, for instance).
I’m not sure I buy his statement that he can’t put her out because it will depress her respirations too much. True, she has a pneumothorax, and she’s in a difficult location to keep a close eye on, but surely they can give something stronger than what they gave her.
The medical mystery of the crane operator was interesting, but only made up a small part of the episode. Still, I give it a B+. The solution was quite a stretch and only deserves a measly D+. The medicine in the hospital was pretty good, even if the solution was poor. I have some serious concerns about the medicine in the field, especially the need for an amputation at that point (and even earlier, when Cuddy originally suggested it), and the use of Streptokinase. Overall, I give it a C. The soap opera was good, though it needed more Wilson (and more Foreman — he really got ripped off this season); I give it a B+.
The review of the previous episode of House
A list of all prior House reviews
House Challenge scores have been updated as of last week’s episode. Final scores should be up tomorrow night.
May 17th, 2010 at 11:07 pm
After reflecting a bit, I think this is probably the most logical way to end the season. Good drama this time.
May 17th, 2010 at 11:14 pm
Speaking of amputations — What would be the pros and cons of amputating House’s bad leg? How likely is it that he would have phantom limb pain that would leave him in severe pain? Would it make a difference whether the amputation was done at the time of the infarction or now?
May 17th, 2010 at 11:20 pm
He’s hallucinating!!
May 17th, 2010 at 11:23 pm
I couldn’t get into this episode. The drama seemed forced and inconsistent. Not much humour in this episode either (for obvious reaons) which killed part of the reason to watch the show in the first place.
Here’s hoping for an upkick in Season 7.
May 17th, 2010 at 11:28 pm
Just for the record…Yes we as EMTs (dependent on state and local protocols) are trained in intraosseous access of the tibia or in cases the humerus. Esp when using the EZ-IO.
May 17th, 2010 at 11:29 pm
At one point when House was down in the garage with Hannah there was a flash to House seated on the floor in his place playing with Vicodin (or something) and then it went back to the garage. Perhaps this is an indication that all is not as it seems.
As for the unwillingness to give Hannah anything stronger, I can remember seeing one of those “Life in the ER” type of shows which are filmed in actual ERs (as opposed to the kind Hollywood uses) and they had a cop who’d been either shot or stabbed in the chest. He was still conscious, needed emergency surgery to save his life, and they told him there was nothing they could give him for the pain. It always struck me as being a bit odd that they didn’t at least give him a local, since that would have helped at least a little bit. Had I been Hannah, I’d have asked for something to bite down on while they cut my leg off.
May 17th, 2010 at 11:37 pm
To Tuckerfan-
that wasn’t a hallucination or ‘all isn’t as it seems’. Remember that most of the episode takes place ‘eight hours before’ the end huddy scene. It shows house at the end before cuddy comes. So that was technichally a ‘flash forward’ to show ‘oh, that injury came from there’.
It might have also been house remembering and reflecting, because as you said it was him sitting with the vicodin and the reason for the middle of the episode was to show how he got there. The stress Almost made him snap and take the drugs.
I could be wrong but I think that was only to remind people that this wasn’t in the present.
May 17th, 2010 at 11:41 pm
Just wanna say, thanks for taking the time to put these reviews together. Very informative.
Despite being kind of lukewarm about most of this past season, I was getting into these last few episodes. House’s realisations about ’sober =/= happy’ and failed attempts at relationships sort of made up for the real move away from semi-realistic medical mystery.
Unfortunately, I find myself agreeing with the review on The AV Club website about the conclusion to the soap opera side of the show.
“Having Cuddy show up at the end is too easy, because it’s what we all want when we’re alone and afraid and miserable. We want the person we love but can’t have to show up at our door and change everything, and that’s not how life works, and we deserve better than to be lied to by shows like this that pretend to dig deeper.”
This is actually a pretty good summation of most of my issues with the show. Season 7 could be interesting but I’m not particularly hopeful…
May 17th, 2010 at 11:42 pm
I know you don’t critique the “soap opera” as you call it, but seriously, I have been waiting a YEAR for that ending! I loved it so much. I jumped and did a happy dance. I just cannot wait to see how their relationship develops. The episode was meh but they totally made up for it in the last five minutes.
May 17th, 2010 at 11:43 pm
Something that bugged me: Cuddy broke up with Lucas? When? Was it right before she went to House’s house?
The ending seemed a bit deus ex machina to me.
May 17th, 2010 at 11:50 pm
The show seems to love that stab-in-the-chest treatment. They used it here, in the Antarctica episode, and at least one other time. Is “open pneumothorax” the same thing as I learned in first aid class to refer to as a “sucking chest wound” (more accurately, as the probable result of a sucking chest wound)? Because they never seem to address the idea that having a hole in your chest wall is generally considered to be a bad thing.
The soap opera felt very abrupt to me, as Cuddy stops just short of telling House to get out of her life forever mid-episode (seriously, it felt that the only reason she didn’t actually fire him right there was that he has tenure) and less than 4 (in-show) hours later shows up at his house in a scene bearing more than a passing resemblance to the penultimate show of last season. Considering that a good portion of that time she would have been busy at the trauma site, that’s a MIGHTY quick change of heart.
More Wilson would have been good, but if Sam has to come with it I’ll pass thanks. On the plus side, we got some non-philanderrific Taub action this week. At least I hope it was. I will be REALLY disappointed if next season it turns out that his concern for 13 is largely driven by the fact that she flashed him a few weeks ago.
May 17th, 2010 at 11:54 pm
It’d suck if the s07ep1 will start with House waking up in his bathroom after hallucinating again.
May 17th, 2010 at 11:59 pm
I can’t have been the only one impressed when they actually showed the carotid system when they were checking for leaks.
May 18th, 2010 at 12:00 am
@Ghost009, what county do you work in?? Maybe as an EMT-P, but we usually just call those paramedics… As for the mass casualty incident, triage tags would have been a nice prop. START triage doesn’t use the glascow coma scale; just check basic mental status. It looked like he was bleeding enough that he would have warranted an “immediate” transport priority with or without the altered level of consciousness. Why wasn’t she administered local anesthetics for the amputation?
May 18th, 2010 at 12:06 am
As ever, thanks for the review, Scott.
A few things that bugged me, even though I’m just a layman and probably dead wrong:
“Stick the IV in her tibia?” I thought you used a special IO needle for that. A discussion of IOs by an EMT here: http://randomreality.blogware.com/blog/_archives/2009/9/14/4321010.html
“The crane driver must have a neurological problem, because he blacked out despite the caffiene?” Couldn’t caffiene poisoning have caused that very symptom?
Can one doctor on his own really carry out an amputation like that? I suppose there wasn’t much room for anyone else down there, but it still seemed odd that House was the only medic.
Medical stuff aside, I found this episode a bit slow in the middle, but it really picked up towards the end. I didn’t really give a damn about the poor crane driver – what was the point of that bit of the story? But then, “Dead patient? What a horrible note to end the series on! How are they possibly going to cheer us up? OMG Cuddy loves him! Hooray!”
May 18th, 2010 at 12:36 am
I’m with Ryon, that was definitely too DEM for me…it wouldn’t surprise me a bit if he were hallucinating again. It also wouldn’t surprise me if this were a side effect of a suicide attempt. I hope the writers have something really good in store for S7EP01. Otherwise I loved this ep!
May 18th, 2010 at 1:53 am
Actually reperfusion syndrome/injury would be the main problem with the potassium going high, the crush syndrome would be later with ck increasing/rhabdo ending in renal failure, bicarb used for potassium (per story) would help out somewhat/maybe. Local anesthetic infiltration, due to the lack of perfusion on the leg, probably would not work due to tissue acidosis. Also, the risk of iv injection would risk seizures or cardiovascular collapse. It seems that the poor lady was going into shock (House worried about inc BP causing more bleeding) and after amputation for sure BP would go down, so any anesthetics would make shock worse plus add some respiratory depression especially with catecholamine depletion which is a real worry in this situation. The needle thoracostomy was a nice touch but has risks of failure plus trauma to certain arteries or organs. Differential to the fat emboli is a venous air embolism which is also a risk from the amputation. As for Cuddy, with the way the writers are, this is probably a hallucination with a really oddball story line for the season premiere or a short lived event.
May 18th, 2010 at 2:00 am
I don’t understand how anyone can say it was a change of heart for cuddy. Not sure if it was in season 5 or earlier where cuddy was the happiest I have ever seen her in the show and was going to House’s office to talk with him. Then she noticed that he was in his office with some blonde woman. She looked crushed.
Also I really don’t mind people critisizing (totally spelled that wrong I believe) the show. However most people who watch this show should focus on the story more then what methods they used and if it was right or not.
This is house, when does he ever do anything by the book.
May 18th, 2010 at 2:18 am
I am still too thrilled so I’ll just say this – if he is hallucinating I am sure Brian Singer will be hanged from a tree by a mob of angry fans immediately after the premiere in September! I’m late for work so I’ll rant enthusiastically later :)
May 18th, 2010 at 2:19 am
I thought the part about not giving too much narcotics in the field before the amputation was about right. To sedate her to the point of pain-free would have cause too much respiratory depression esp. with the pneumothorax. Could they have intubated her in the field and then given her a heavier dose of narcotics? I guess in an emergent situation there’s no time for all that.
You can’t give streptokinase push bolus like that due to profound hypotesion.
Did anyone catch Wilson answer his dirty cell phone then go right back to suturing? gross!
May 18th, 2010 at 2:26 am
Is anybody else a little tired of close ups of Cuddy’s eyelashes blinking slowly as she Registers Emotion?
May 18th, 2010 at 2:40 am
I’m a medical writer who has interviewed several patients, among them a physician, who experienced almost immediate, significant effects from thrombolytics including (years ago) streptokinase. These people were all given the drugs in the ER for heart attacks or strokes, not for pulmonary embolisms.
Re the question “Can one doctor on his own really carry out an amputation like that?” There was a true story a few years ago about a hiker in Colorado who got pinned under a rock. He was alone and was going to die if he didn’t get free, so he amputated his own arm. No kidding.
I usually don’t like season finales that rely on disasters to ramp up the drama. The ending of this episode of “House” made it all worthwhile, however. The death of the patient and the final scene with Cuddy were unexpected but believable, a commendable combination at a time when many TV shows are too predictable or far-fetched.
I agree that humor is one of the major reasons to watch “House,” and it was of necessity absent from this episode. I also miss Wilson, whose interactions with House have presented many opportunities for laughs over the years. I can’t stand the ex-wife, Sam. I hope she gets hit by a bus next season.
May 18th, 2010 at 2:55 am
at whoever asked the amputation question; i’m not a doctor but i think it would’ve been best if they amputated the leg while the infarction was messing things up. had they now he’d still feel pain and would have trouble walking so it really wouldn’t make much of a difference for house.
as for the crane operator, wouldn’t a neurochemical imbalance or an issue with the “wiring” of the brain play a role in his symptoms? sure we know what caffeine intoxication can do, but would it to that extent?
i had issues with the scenes in the rubble, some of which were previously addressed.
I also agree with the comment on the ending, it seemed a bit deus ex machina in my mind as well. Don’t get me wrong, as much as a lot of people would want a Huddy, I’d rather have a Hirteen (house and 13). IMO both are cavalier in certain aspects, have almost similar attitudes toward certain kinds of people. Both have done drugs and engaged in other self-destructive behaviors. If you think about it, they’re more perfect for each other than house and cuddy are. That’s just my opinion.
Thanks Scott for posting medical reviews of this show, for it is interesting to read how an episode progressed from a medical perspective. Looking forward to reviews for season 7.
May 18th, 2010 at 3:08 am
Every EMT has ketamine on board. No respiratory depression, that was a major major flaw in the episode. House is finally being no better than Grey’s Anatomy…
And the “From the Darkness Into the Light” scene at the end was complete bullshit, too.
May 18th, 2010 at 3:24 am
I actually really enjoyed the ending, obviously it was a bit hollywood happy movie ending with no realism in it but due to him having given up on his therapist in the penultimate episode and having gone through 6 long years (seasons) of depression/battle with addiction/etc it was nice to actually see a HAPPY ending to a house season.
Season 5 ending? ODing on Vicodin checking into mayfield.
Season 4 ending? Amber dies House almost dies and Wilson deserts him.
The other seasons didn’t have particular ending but my point is obvious. Why is it not allowed to have a cliche but happy ending to a season?
May 18th, 2010 at 3:30 am
There was a quick little medical thing that I loved: House notices one victim’s toes are purple and realizes it’s a sign of atherosclerotic emboli in a smoker. Lets him die. Cool.
May 18th, 2010 at 3:32 am
I guess this was an ok way to prep for Season 7 but did anyone else notice that even AFTER Cuddy told House that she left Lucas for good b/c she loved him, that House couldn’t bring himself to say it back to her even though it choked him up and *almost* brought a tear to his eye?
It would have been a more believable ending for those that wanted “Huddy” for him to say it back to her so they could go riding off in to the sunset, hand in hand to Season 7…
I was surprised that the swerve they faked us out with (House relapsing on alcohol and/or narcotics) was merely a red-herring designed to keep people from thinking about the ‘Huddy’ angle that was mostly neglected this season…. Yay for something that the writers got right.
Things probably won’t be as rosy next season as people hope they will be based off of what they think the direction is that this went in during the last 3 minutes….I predict that PP will be a very interesting place this fall with Remy asking for a leave to deal with her Huntington’s… (kudos for those who picked up on her hand tremors at the lesbian bar), Taub’s continued marital flip-floppery & Wilson’s re-engagement to Sam.
Did anyone else notice that the only two who were “drama free” at the end of this were Foreman and Chase?
Let’s hope the writers get their collective $h!t together during the off season and get some quality (not hollywood) back in the show for Season 7 else the franchise is in real trouble.
And last but certainly NOT least, a BIG thanks to Scott for letting us all hang out at his place Monday nights and relax while talking about our favorite medical drama… Without this place, the world would be a little less friendly….
I hope to see all of you back in the Fall for the start of what will hopefully be a renaissance and a resurgence in quality to the best show on TV..
Till then..don’t be idiots….. :)
-H
May 18th, 2010 at 4:02 am
All through this episode I honestly thought this would end with House incoherent on his bathroom floor, having gone back to his addiction (as addicts do). That would have been a typical lame TV-style “none of that actually happened” episode but to be honest it would’ve been stronger than having Cuddy come out of nowhere. Not to mention more believable…
May 18th, 2010 at 4:20 am
One point that I think has been overlooked (so far) is that, despite his efforts to keep the patient at a distance (sometimes literally), House ends up bonding with her anyway, and that’s why he comes apart when she dies. Surely a senior physician like House already knows that a doctor can do everything right, and still lose the patient. But this is the same Dr. Gregory House who actually seemed to take pride in “not giving a crap” about his patients as people; Hanna broke through his detachment in a way that not even Dr. Cate Milton did in the 4th season episode “Frozen.”
I thought it was a nice offbeat moment when Hanna asks House to pray with her, and House has to say he doesn’t believe in God, whereupon Hanna says she doesn’t believe in God, either – I’m reminded of that hoary chestnut about how there are no atheists in foxholes.
And yes, I kept waiting for Cuddy to magically disappear after her big speech about breaking up with Lucas and not being able to stop thinking about House. I had absolutely no problem with Cuddy showing up to check on him, but what she had to say did seem a bit too neat, too much of what House *wanted* to hear.
May 18th, 2010 at 4:59 am
If the writers re-used the hallucination angle AGAIN to end a season (like they did the whole half of Season 5) then this series is certainly wrecked beyond any hope of repair….
Lets hope not.
May 18th, 2010 at 5:28 am
Hallucination or no, this may well be regarded as the moment when House jumped the shark.
May 18th, 2010 at 5:49 am
Thanks for the medicine, Scott–I had a question about the Hanna case which you answered. The crane operator story did seem to fade out abruptly–maybe it wasn’t the arachnoid thingie after all…? I actually wondered if I might have missed a final tag scene.
I think that House, when listing to Cuddy possible complications of amputation, mentioned “fat embolism,” pointing up the tragic aspect. And he did make it clear that the streptokinase was dangerous. As Scott notes, the pneumothorax (not “cured”) sets up the need to operate without anaesthesia. I felt that the writers were at least putting some effort into the medicine, though perhaps only in service of the drama.
I thought this was an interesting complement to the previous episode, in which House explains that he thought if he tried to be good he would be happy (as Hanna also thinks). Strange that the sophisticated cynic of season 1 has turned out to be so naive. Presumably the finale is not a hallucination but a case of “be careful what you wish for.”
I thought that House came close in this ep. to becoming Wilson, the guy who holds the hand of his dying patient.
May 18th, 2010 at 6:04 am
The EMTs seemed fairly incompetent to me in this one.
How’s their knowledge amount for accuracy, anyone who knows?
May 18th, 2010 at 6:50 am
I am not very crazy about dark disaster scenes. However, it is interesting to see how House is developing over the past few episodes into a person who, in his own dark way, is almost nice to people. I hope they give his relationship with Cuddy a shot on the show. It would certainly make for a whole new face for the program.
13 taking some time off–well, I hate to say it, but I would enjoy some new fellows about the place. I have never liked Taub and he becomes more despicable in each episode. Foreman has foibles. Chase is flawed.
I would have enjoyed a bit more info on the crane operator’s medical condition in the show, but thank goodness for Scott’s analysis to save the day.
I presume House did not get his cane back–was there a symbolism in the shot showing it left behind? I hope his motorcycle was retrieved!
May 18th, 2010 at 7:22 am
Anyone note the cane being left behind? Wonder what that’s about. I have a feeling there’s more than meets the eye and not neccessarily him hallucinating. I think they want us to think he is. Or at least question. But that cane..I’m thinking means something.
And did 13 kinda creep anyone else out? She was almost like crazy looking. Which might be the point. I was more impressed with her acting as the season went on.
And yes, more Wilson is ALWAYS needed.<3
May 18th, 2010 at 7:45 am
People are complaining that the ending was very convenient and unrealistic. For the first time in six seasons, the main character has a real chance to be happy. It has become more and more apparent as time goes on that House is just as human as anyone else, and he does want to be happy. To me, it seems that he has tried his hardest to get on with life, only for everything to crumble around him each time he tries. I am disappointed that the medicine has taken a bit of a back seat as of late, but the character of Gregory House is the only reason I kept watching the series anyway.
May 18th, 2010 at 8:23 am
imo this episode should of been the series finale.. 13’s huntington’s coming around.. the hookup.. i think we got the ending we got in case the show doesnt come back next year
May 18th, 2010 at 8:28 am
Like a few other commenters, I am leery of whether or not that really was Cuddy and not House’s brain but a couple of things argue against it:
Last year he was dosing the Vidocin pretty heavy – and that was the explanation for the hallucination of them getting it on. He’s not gone back to the Vicodin yet, so why exactly would he hallucinate Cuddy coming to save him and declare her love?
It would also be really bad to turn this into a “Bobby Ewing in the shower” moment.
I just don’t know whether to give the writers credit for teasing the relapse so hard then delivering the big swerve to produce the long-awaited “Huddy”. There’s a lot of dramatic potential in this new relationship but at the same time I don’t want them to “fix” House any further.
May 18th, 2010 at 8:37 am
One of the most interesting things about the episode in my mind was that the entire episode was shot on a digital SLR. When you think of the size of normal film cameras, the fact that technology has gotten to the point where you can shoot HD video with a small SLR is pretty cool.
May 18th, 2010 at 8:47 am
The cane left behind… My interpretation.
House has real pain from the leg but the pain is psychological, as we saw long ago when Cuddy gave him a placebo which affected him like morphine. Remember that the leg operation alienated him from his wonderful girlfriend–he saw it as a betrayal on her part.
After House did the right thing by Hanna, after bonding with her, he was sufficiently pain-free to forget his cane. For a moment, doing good meant feeling good. After she died, walking into the hospital, he almost collapsed. He did good but he did not feel good. He is not Wilson, cannot be Wilson.
Basically he needs Cuddy or Vicodin–as a crutch, so to speak… I must admit that I think the most satisfying ending would have been for him to flush his stash, without Cuddy appearing, but maybe that would be too extreme.
BTW, isn’t Cuddy being rather cavalier in dismissing her baby’s father-figure? What will she say when Rachel (?) asks where Lucas is?
May 18th, 2010 at 9:01 am
So many ideas in this episode. First, House bonding with the patient, then not being able to deal with her dying. Yes, he’s always stayed away from patients, but I’ve always thought that was the result not of being totally insensitive, but of being too sensitive. He’s built all these walls around himself to keep people from hurting him. And he let a wall down in this episode and look what happened. I honestly thought he was going to overdose on the Vicodin to try and kill himself at the end.
Second, Cuddy appearing actually surprised me. Last season, we expected something to happen between them in the last two shows. This time, I didn’t expect it at all. I have to say that, unrealistic as any happy ending for them may be, this felt just as good as Carrie and Mr. Big finally working it out at the end of Sex and the City. Lots of us have that bad boy in the past with whom nothing would really have worked, but we dream about it anyway. It’s nice to see if happen for someone else. :-)
Third, 13 asking for time off. I’ve been on a House episode watching marathon, and I think there are some clues that 13 and Taub may actually be involved. And there was one very obvious look they exchanged last night that made me wonder if that’s what’s behind her wanting to be away. That, plus their dialog in House’s office at the end.
And last, was it a hallucination? I agree with D-r Bulgaria that if it was, Bryan Singer might need bodyguards. UNLESS, that is, this entire season has been a hallucination. I don’t see how they dare do that after the uproar (and endless mocking) over the Dallas season that was a hallucination, but if it was, these guys would make it interesting. I’m hoping they’ve just decided that they’ve danced around it too long and they, like Cuddy, have to find out if it could work. I can’t wait to see what happens next season.
May 18th, 2010 at 9:22 am
“at whoever asked the amputation question; i’m not a doctor but i think it would’ve been best if they amputated the leg while the infarction was messing things up. had they now he’d still feel pain and would have trouble walking so it really wouldn’t make much of a difference for house.”
Thank you, bryce. On various boards and lists, whenever the subject of House’s pain comes up, someone writes that he should “just” get the leg amputated so he wouldn’t be in pain any more. But it doesn’t necessarily work that way.
May 18th, 2010 at 9:36 am
“The soap opera felt very abrupt to me, as Cuddy stops just short of telling House to get out of her life forever mid-episode (seriously, it felt that the only reason she didn’t actually fire him right there was that he has tenure) and less than 4 (in-show) hours later shows up at his house in a scene bearing more than a passing resemblance to the penultimate show of last season. Considering that a good portion of that time she would have been busy at the trauma site, that’s a MIGHTY quick change of heart.”
This seems to sum up a lot of the criticism of the final scene, but after thinking about it, here’s my interpretation of Cuddy’s action throughout the episode: Cuddy had already turned down Lucas’ proposal before the episode started. She realized that stability was important, but when it came to “forever”, she couldn’t do it because of her feelings toward House. She wanted to believe that there was a chance for them. However, House’s actions during the beginning of the episode led her to believe that it was not a possibility..he would never change. This disappointment led her to say that she didn’t love him and that basically, he treated his friends like crap. However, as the episode unfolded, and she witnessed House’s interaction with Hannah, she was very moved and decided to give it a try.
I actually think her actions were quite consistent….but how did she get into his apartment?? He left the door unlocked? She has a key?? P.S. This was NOT a hallucination. It will not go smoothly for them, and if it brings back the snarkiness, even better. Will his team be aware of their new relationship? How do they handle the employer/employee relationship?
I also don’t understand Scott’s criticism about the amputation. She was trapped under the rubble with no chance to get her out. It was tried and it caused further collapse. If they had amputated when Cuddy wanted to do it, I think she would have had a better chance for survival because her overall condition would have been better.
May 18th, 2010 at 9:47 am
@ Judy:
“BTW, isn’t Cuddy being rather cavalier in dismissing her baby’s father-figure? What will she say when Rachel (?) asks where Lucas is?”
Does it matter? Since Cuddy did a “Brangelina” & Rachel is adopted, Lucas wasn’t her father anyway….she can just go back to being her mommy like she was before Lucas ever came around.
May 18th, 2010 at 9:47 am
The 10, 15 mins tops, of House and Cuddy talking about non-medical stuff in this episode was great. The phone calls back to the office to treat the crane operator were ok but something that had already been done before more than once. Everything with Hannah just seemed forced and almost surreal, like everyone was just going through the motions. Also, I have a hard time believing House, as a person that prides himself on rationality, would think “There’s someone under there and I’m the best doctor here plus I have a bad leg so I should crawl down there and help her.” No, I didn’t buy that as being genuine even for a second. It just doesn’t fit his character at all. He also used the phrase ‘Begs the question’ when he really meant ‘Raises the question’ which bothered me more than it should, perhaps, but is still not a mistake House would make.
May 18th, 2010 at 10:01 am
I actually think that House WOULD have gone after what he was quite convinced was someone trapped under the rubble, not out of some sense of altruism but rather because he’s stubborn. He was quite convinced that he was right and that there was someone down there. He is prone to doing dangerous, stupid things to prove himself right, and I don’t see how diving into the rubble is much different than self-experimenting or dosing himself with physostigmine.
May 18th, 2010 at 10:20 am
“Having Cuddy show up at the end is too easy, because it’s what we all want when we’re alone and afraid and miserable. We want the person we love but can’t have to show up at our door and change everything, and that’s not how life works, and we deserve better than to be lied to by shows like this that pretend to dig deeper.”
Oh, no, no. You see, bad endings can get too predictable when you’re talking about a TV series that runs for a few years. That’s the whole point — it was totally *expected* that House will be going back on drugs — and that would be simply boring! Come on, we’ve seen enough of his misery and self torture already, they squeezed everything they possibly could out of that. They needed to move on, to create something new. A surprize. A relief. As an ending to season 3, I agree, this would have been lame! But now? Best thing they could do! Actually, I believe this should be THE END.
May 18th, 2010 at 10:33 am
Interestingly, each of the first five seasons ended with something depressing happening to House:
1st season: Stacy and House “separation”
2nd season: House is shot and has a strange dream episode
3rd season: Chase, Foreman, and Cameron all leave the team in some way
4th season: The Amber catastrophe
5th season: House ODs on vicodin and is admitted to a hospital
So finally we get something of a happy ending to a season. It’s about time. :)
May 18th, 2010 at 11:08 am
I spent the day busy with usual worries at work (including patients unwilling to pay), but at the end of the day I remembered what was the reason I smiled when leaving the House. I carefully thought it over and over again and I see 3 possible beginnings of season 7:
1. House wakes up to find he has OD on Vicodin and have hallucinated the whole thing (bad s**tty solution and it would be also REPEATING of an idea and that is never good on TV. Least favored solution – I certainly hope that the writers and the producers are smarter than that. Starting the next season on the same music as this one is just plain stupid.
2. House attempted to suicide with a high dose of Vicodin he is comatose and is dreaming the whole thing, he wakes up in the hospital to find out that Cuddy did call off the whole engagement thing out of guilt and love or that she is already married (well that would be a perfect solution for somebody who loves bad endings – we already had 5 seasons ending on a band note how about a little happy ending just for a change? I’m going back to my idea of hanging Brian Singer, or may be using tar and feathers)
3. It is all real and I did not almost cry while smiling this morning just to be hit in the face with a dose of cynicism (hurray Huddy!). The proof for this – House asked: “What if I am hallucinating again?” While Cuddy’s answer was idiotic (if he is hallucinating he could have easily hallucinated NOT taking the pills while he have taken them) it IMO was the producers and writers way of telling us “Smile you guys this is real!”
To stop me from crying again I will switch to medicine which was almost absent this episode but the small stuff present was nice and messy:
1. Caffeine overdose is a good way of losing consciousness or falling asleep after it’s action wares off. It should have been included in the differential.
2. Crush syndrome and rhabdo and re perfusion syndrome are all bad things – however for House to suggest treatments BEFORE the leg is released is stupid. None of the things he suggested would have worked while the leg was still there.
3. Local anesthesia is a valid way to kill of pain for that kind of amputation. The best idea would be spinal anesthesia with lydocain – however here it seems impossible because the patient cannot roll. So infiltrating the nerves with lydocain above the crush site and below the waist line would do the trick. I have witnessed semideasarticaluation (removing of half the lower jaw) on local anaestesia and I know it could (probably) be done for extremities as well.
4. The final diagnosis for the POW did not seem to match the symptoms at all. But our guest already complained about that so…
I REALLY REALLY am hoping that this was genuine happy ending and not some kind of lie (any kind). The next season would be funny intriguing and dramatic enough just by watching these two putting their act together. I mean this is House we are talking about – him in a committed relationship, with a baby in his hands. Fun, fun, fun :). I bid you all farewell until September but I’ll check and read to see if there is any news here – and I would also like to thank our host here – this blog rocks! I enjoy it almost as much as the show now – so keep up the good work. TTFM!
May 18th, 2010 at 11:14 am
I just passed my Paramedic exam last week, and we spend a decent amount of time on crush syndrome. It begins to set in as early as an hour after the patient being crushed.
May 18th, 2010 at 12:01 pm
Just my own (probably completely off) musings, but does anyone else suppose that the episode could have been an hallucination but, wait for it, that it was actually Cuddy who was trapped under the building and died, forcing House into depression, Vicodin, and a drug fuelled psychological barrier against what actually happened?
May 18th, 2010 at 12:04 pm
wow….thanks for all the medical reviews~~
it’s really interesting to read all the comments
but also confusing cause some of the medical stuff are contradicting…lol
Q: do patients always die from fat embolism when their situation is as bad as hanna’s?
P.S. loving the ending!!! kinda sudden
but after all, it’s a DRAMA~~
May 18th, 2010 at 12:04 pm
the problem with the ending, is that nobody ever believed for a second on the Lucas-Cuddy relationship
he was good looking, smart and young, so a woman with a baby, who’s at least a decade older is very likely to want to have sex with him and even have a semi casual relationship
moving in together might be a stretch but in no way she’s going to marry him
it was all done for House to be jealous but the problem is that it wasn’t done by Cuddy but by the writers
Cuddy is not the kind of character that will form a relationship just to pissed House off, and neither she’s the kind of character that would marry to Lucas
so it doesn’t work either way, so the ending rings false
May 18th, 2010 at 12:25 pm
When House measures Hanna’s BP, he uses a sphygmomanometer, but no stethoscope. I am aware that you can get an approximate systolic blood pressure by palpating the radial artery while inflating the sphygmomanometer’s cuff, but is that really sufficient in this case?
May 18th, 2010 at 12:34 pm
I felt the whole crane operator story was a bit tacked on. I’d rather just cut that out and focus on House, Cuddy, and Hanna.
I’d rather the “mystery” be based on house in the present flashing back to the events of the night before. The viewer trying to figure out how he got to his end state. (also the scene of him ripping the mirror from the wall would have been an excellent way to start the episode)
This episode felt really rushed. Cuddy tells House she’s engaged, and then by the end of the episode she’s broken up and admits to loving house? I feel like they wanted to do another two-hour episode but were forced to do only a one hour one. Then they decided not to cut anything (It would make the fact that they abbreviated the opening sequence make sense).
Overall, I think I would have enjoyed the ending more if after Cuddy admitted her feelings, she told House that they have no real future. Kind of a reversal of what he did to Stacy. That way season 7 would be about Cuddy and Lucas getting married and House being miserable.
Overall, a pretty lackluster episode. I felt that the scenes with Hanna and House alone would have been worthy of an episode (There certainly was enough detail there), without the need to interject a bunch of random drama into the mix.
* Oh, and I’m a little sad that we didn’t get a close on House’s psychiatrist. It would have been nice to have House go to him after the events of the night and end with them reconciling.
May 18th, 2010 at 1:14 pm
“The MRI is normal, but the crane operator starts bleeding from both the nose and eye, suggesting something is wrong”
It wasn’t just a psychic nosebleed?
Sorry if someone got to that already – I’m at work and didn’t have time to read *all* the comments.
May 18th, 2010 at 1:17 pm
Did anybody notice that in the first scene – the one before the flashback – House’s ear was bandaged, and at the end, it wasn’t? I wonder if that’s a continuity goof or a clue?
May 18th, 2010 at 1:19 pm
Why do people think its surprising Cuddy has a change of heart from earlier in the episode when she was mad at him? Obviously House’s heartfelt acknowledgment of how his pain has affected him and his realisation that he is wrong to try and avoid amputation because of his own experience shows Cuddy that he is, perhaps, moving on – he also actually listens to her when she tells him to move on, which I’m sure didn’t go unnoticed.
May 18th, 2010 at 1:33 pm
I am going to stand by my original premise: House and Cuddy is a BAD idea. Being in love (or getting shagged regularly) will NOT overpower addiction. House is clearly still dealing with his addiction issues – and is still drinking – and that is NOT going to change any time soon. Once that first romantic blush wears off and tie tide of endorphins and dopamine recede, he’ll go right back to his addictive behavior. And Cuddy pretty much gave him permission to do so by telling him that it is his choice if he wants to take drugs. He’ll throw that remark back in her face at some point: “But Mommy, you SAID it was okay!” I like Cuddy, but I’m very disappointed that she is taking such a risk with her own license. A physician who hooks up with a known addict? Most docs aren’t that stupid; its too big of a risk. The first prescription pad House steals is gonna be hers.
And my fellow bloggers are right: this episode did make paramedics look like idiots. That’s a shame. EMT-P’s are very intensely trained and, in most cases, more qualified to handle these types of disasters than many physicians. For example: House “black tagged” a victim because he had blue toes and he therefore surmised that the guy was a smoker with atherosclerosis and therefore probably couldn’t be saved? Hippocrates is spinnin’ in his grave! An ER doc would’ve had more balls and a paramedic never would have left the guy behind. Sad.
May 18th, 2010 at 1:57 pm
One thing I’ve always wondered, with a field amputation like that, how do you keep the patient from bleeding out before you get everything closed off?
May 18th, 2010 at 2:07 pm
“Most of tonight’s medicine was trauma medicine, and area I (thankfully) don’t practice much in. I’d like to hear what any emergency physicians, paramedics, or EMTs thought.”
Trauma is actually primarily the turf of surgeons, not ER docs.
May 18th, 2010 at 2:59 pm
this episode really shined a light on how bad the season was. I didn’t know it was the season finale, but i had a hunch, because they usually bring out the heavy soap opera near the end. It was a good episode. better then every episode this season.
May 18th, 2010 at 3:13 pm
First of all, I’d like to remind everyone that although House has a number of medical inaccuracies, it is one of the few tv shows in which you need actuall knowledge to spot the mistakes. Most series and movies have such huge errors that a highschool education can point out. Also, the actuall drama is great. All of the characters are believable -even House. If you read the biographies of most geniuses, they where very hard to deal with and most had major communication/and or relationship problems, not to mention actuall mental instabilities. For this episode, many said that they found Cuddy’s change of mind “not really plausible”. Well, remember that she had been in love with him waaaaay back and that is not something you easily get over. I mean, come on, most of us actually know of more screwed up behaviour by people being “in love”, abandoning families to run off with someone who others consider “a piece of cr@p”. It was a very intense episode and I liked the proposed idea (something very rare in american shows – sorry to americans, no malice intended) that bad things happen to good people and vice versa. You can be the best guy in the world, but if she doesn’t love you, it sucks and that’s just how it is. I would like it if House and Cuddy would be together, but I’m afraid it would mean the end of the series. Although, unless the show wants to go bad, it can’t go on more than the next season. House has been annoying, miserable, to the dumps, up again and down again and maybe up again. Time to wrap it up and leave us with the fond memory of a great show, not the undying corpse of something that used to be good. To a good final season.
May 18th, 2010 at 4:17 pm
Oops – I was wrong. I went back and watched it again, and it wasn’t his ear that was bandaged in the first scene, it was his shoulder. I know – ear, shoulder – they look so much alike. In all fairness, the camera angle was odd and it was in close enough that it was hard to tell.
I will say that parts of this episode were much harder to watch knowing how it was going to end. Watching House open up to the patient was painful.
I believe I read in one column about House that Katie Jacobs said they were going to introduce the idea of a character’s pregnancy in the season finale. To go along with my theory of 13 and Taub, I bet it’s 13. That’s the appointment she had that made her late – not a rescheduled therapy appointment. It will be interesting to see what happens. Bring on season 7.
May 18th, 2010 at 4:18 pm
Thank you, thank you, for these excellent explanations and the fun discussions they lead to.
May I ask a question that has been on my mind forever, though it is not relevant to this show?
Do diagnostic doctors ever break into patients’ homes to look for disease causes? Is that ever legal?
May 18th, 2010 at 4:23 pm
1. At the beginning, when Cuddy asked House how he’d found out ((about her engagement with Lucas)), I assumed she was referring to engagement and that House had made the same assumption, with his comment about their cohabitation (i.e., I thought he was saying that the cohabitation was obvious enough, and that he’d surmised that they’d moved onto the next step, engagement). So naturally I was surprised later when the engagement was “revealed” and it turned out that the book was a boyfriend-moving-into-your-house gift. Didn’t know that that event occasions a gift. Shows what I know.
2. In the mid-episode flash-forward to House in his bathroom, my expectations were again dashed. I assumed that a paramedic or fireman had naively slipped House some Vicodin to deal with his collarbone injury. Given the extent of his recovery I was surprised that he’d kept a hidden stash all season-long. (I will have to look back through earlier synopses as I seem to recall a scene early in the season where he discarded all his little stashes hidden throughout the apartment, making this seem like a contrivance, although I suppose the same could have been said of House finding a vial of Vicodin in the pocket of a trauma victim.)
3. Would have preferred that they’d dumped the B-mystery of the crane operator but focused more on the team. I feel that in recent episodes they have developed a nice chemistry, and so I would have liked to have seen greater involvement of the team in House’s impending relapse. Granted, Foreman showed a bit of concern, but gave up on cheering up House after only a couple tries. I would actually have enjoyed a sappy “power of friendship” ending, like with Chase, Taub, Hadley, and Foreman all showing up at House’s apt and taking him to a strip club or something. After all, a support network is most effective in aiding recovering addicts.
4. House parting with his cane sometimes indicates that we are witnessing a dream sequence; however, those are also accompanied by strange inconsistencies and pain-free walking, whereas House was in a great deal of pain sans cane this episode. I think he hung up his cane in order to induce greater pain and increase his likelihood of relapse. Could be that the entire episode from the secondary collapse onward was a dream, but we’ve already been there when House was shot. Could be he went home after hearing the news from Cuddy, got high, and hallucinated the remainder of the episode, but we’ve been there too, so I am going to vote no on the hallucination question.
May 18th, 2010 at 4:40 pm
To add to Cantare’s point about the ear bandage I will note that when Cuddy visits at the end, she is wearing her pink scrubs and not her street clothes. Also, I didn’t notice her bringing in a bag with the fresh bandages she said she was going to change for him. Might need to roll the tape on that one.
House has suffered compound and complex hallucinations before. That should be considered before any happy endings I’m afraid.
May 18th, 2010 at 5:10 pm
True, a lot of paramedics I have met tend to have more knowledge than this episode let on. However, I have seen some really idiotic moments.
The first moment I ever encountered was during my 3rd ride. We never made patient contact. However, the patient’s friend (who was speaking clearly with no staggering) had told us the patient had dissappeared. We’re about to leave when one of the fire paramedics yells, “STOP!” We all freeze and turn around, expecting something intriguing. The fire paramedic shines approx. 50 lumen flashlight into the poor guy’s face and says, “Tell me your name.” The guy says his name. “Tell me what day it is and what time it is.” The guy stares at this paramedic bewildered and says “It’s saturday and it’s” looks at his watch “12:30 am.” The paramedics I was riding with shake their heads and motion for me to follow them back to the bus. “‘Cause I would’ve thought that guy was way too drunk to tell us anything, too….” I heard one of them mutter.
Did that paramedic really think that guy was hyped up on ANYTHING?! Clear, normal gait, normal speech, a little uppity because there are EMTs, Cops, and Paramedics EVERYWHERE (I think we were all really bored that night). But there was no way in hell this person didn’t know what he was talking about.
Now don’t get me wrong! I have seen some amazing paramedics deduce crap I’ve never even HEARD of and have it work! But they have their retards too!
May 18th, 2010 at 5:11 pm
Jay, you don’t think House has a first aid kit?
Gad, some of you just want House to be miserable forever. She loves him and he (to the degree that he is capable of) loves her. It’s not a dream or an hallucination or whatever you can think of. House IS capable of relationships. He had one with Stacy for several years until his leg became more important to him than she did. (Never understood that!) It’s going to be fun watching them try to wend their way through this land mine. I don’t think this relationship will be the focus of future shows (and they WERE renewed for another year), but will percolate in the background, as it should.
May 18th, 2010 at 5:27 pm
doa766- Who’s to say an older woman wouldn’t want to have a relationship with a younger man, looks aside? My stepmother is seven years older than my father, and obviously they have more than a “semi-casual relationship.”
And I believe Cuddy doesn’t do ANYTHING that the writers (or to a lesser extent Lisa E) don’t tell her to ;)
May 18th, 2010 at 6:22 pm
Can someone explain why they cannot simply dig down rather than take debris of the top? I mean, the leg is trapped right? So couldn’t you simply start digging below the leg which would put more space between the building and the floor, which allows the foot to get out?? It seemed that the woman was laying on a type of dirt floor…so is there a medical reason they couldn’t do that?
May 18th, 2010 at 7:36 pm
“It’s my Leg!”
nice one – we heard that before (”Three Stories”)
May 18th, 2010 at 7:53 pm
This is just a comment from an ignorant TV watcher who has never seen an actual disaster. I thought the EMTs looked pretty good in this show. Of course House and Cuddy (and Scott and some folks on this comment board) know more than they do, but I thought they came across as brave and knowledgeable. The fact that they didn’t want to go into the parking garage when only House had perceived a sign of life was not negligent–they had tried several ways of finding something and they had more certain cases to work on. (I agree with smidget that House’s pursuit of his belief in what he heard was pure cussedness.)
May 18th, 2010 at 8:39 pm
High doses of caffeine can have a paradoxical sedative effect on some people, apart from the usual dysphoria, jitteriness, and anxiety.
May 18th, 2010 at 8:55 pm
@ruthinor … my wife (the REAL House fanatic in this … er … house) pointed out that she could have broken up with Lucas last week sometime, and just have been lying to House (and possibly herself) when she was going off on him.
I stand by my earlier position regardless. That doesn’t mean I don’t LIKE the ending; it could be a lot worse than it was and still be just ginger-peachy if it means that Lucas is gone. Last season, as a quirky sidekick, he worked. This season, he was okay though not great in the opener and went sharply downhill from there (probably the worst point was the episode where he was playing some really mean-spirited practical jokes on House and Wilson).
@James: I wondered about that too, so I looked. She’s laying on the concrete floor of the parking garage. Not actually impossible, but a lot more difficult than if they just had to move some dirt.
May 18th, 2010 at 10:02 pm
Really, the ending was going to either be House OD’ing and dying (or coming close) or being pulled from the edge. It was one way or the other. Else, there wouldn’t really have been an ending at all. Though House tearing his place apart for his last little secret stash of drugs was great high tension moment, they kind of painted themselves into a corner with it. I seriously doubt they go back to a Bobby Ewing in the shower twist, what happened happened.
Lame way to write out Thirteen. I’ve not really been a big fan of her character for a while, and I don’t necessarily mind her being written out, but “Obviously I’m not okay” was it? Just, her Huntington’s is getting worse? ‘Kay. Couldn’t she have taken Taub out with her?
I wasn’t expecting to get Happy House this quickly. Not really sure what season 7 holds now.
May 18th, 2010 at 11:08 pm
everyone whos not buying the huddy thing in this episode seems to have missed the under current of affection between the two that started straight from the get go in season 1. this wasnt sudden or abrupt, it was the realisation of 6 years of fear, pain and lost chances between the two characters. her interactions with house, even when she became a mother and seeing lucas, always had that something extra thats never apparent when she talks to anyone else.
it’ll be interesting to see the dynamics of the relationship in the next season. some of you guys wanted more humour? well this relationship is a right ol breeding ground of jokes and one liners.
i do agree however with some ppls hatred of wilson’s ex. may she meet head-on with a large motor vehicle in the near future.
May 18th, 2010 at 11:59 pm
Bob, I agree with your wife. My reading of the situation is that Cuddy turned down Lucas well before the last episode began. When it came to a proposal, she just couldn’t do it. The idea that she broke it off DURING the episode is ludicrous. Of course she wasn’t going to tell anyone about this. Couldn’t tell Wilson, he’d just go and blab it to House. Couldn’t tell House because their situation has been so up in the air. When I see so many folks on this and other fora talking about how “cruel” Cuddy has been to House, my jaw just drops. Telling her she’ll be a horrible mother, grabbing her breast when she’s trying to further their relationship…these are just the ones I remember off the top of my head, with respect to House’s cruelty. In fact, the more he seems to care about someone, the worse he appears to treat them, Wilson being another example. I hope they go to her place (remember Rachel?) and take a shower together and then whatever happens, happens!
May 19th, 2010 at 1:19 am
@tom: interesting nod to e.e. cummings.
May 19th, 2010 at 2:41 am
Count me among those who groaned when Cuddy showed up at the end. First of all, do not for a second think that it’s going to be rainbows and sunshine from now on. House wasn’t depressed because of no Cuddy. He was depressed because he’s a miserable person.
Second, it was ridiculous how her attitude did a complete 180. And more ridiculous how she didn’t recognize his “niceness” as manipulation intended to bring this very result, and not the actions of a truly changed person.
Third, every show that dissolved the romantic tension has died soon afterwards. When you play your best hand, where can you go from there but down?
Fourth, it just doesn’t happen like that. Once you’re in the friends zone, you’re there for life.
And I believe House changed the story anyway when he was talking about amputation. Sometime back, one of them asked whether House was a prick even before his infarction. The other person (Cuddy? Stacy? I don’t really remember) said that yes, he was. Now he’s claiming it’s his leg that turned him into the person he is today.
May 19th, 2010 at 4:28 am
I don’t believe the ending was another allucination. That would be lame and lack originality.
However i do believe, that at some point at season 7 he will ruin this potential relationship with his usual self pity, misery and rudeness, inspite of cuddy’s best efforts to keep this thing going, as he always has done, because he’s just being house.
May 19th, 2010 at 4:39 am
Stop crowing you Nay-sayers! It will work. It will not be just buuterflies and roses but it will work, those two deserve some happiness and they both desperately need it!!!
May 19th, 2010 at 7:04 am
@Alex: don’t forget that it was House’s generosity (underpinned no doubt by fear of having to sacrifice a percentage of his self-pity, misery, and rudeness) which ended the relationship with Stacey. I was touched by House’s admitting that he has a long way to go before he will be able to meet Cuddy’s needs.
May 19th, 2010 at 7:07 am
Thanks!
May 19th, 2010 at 7:17 am
Ok First to the question about Houses’ own leg
LabbRatt
May 18th, 2010 at 9:22 am
“at whoever asked the amputation question; i’m not a doctor but i think it would’ve been best if they amputated the leg while the infarction was messing things up. had they now he’d still feel pain and would have trouble walking so it really wouldn’t make much of a difference for house.”
I don’t think we have ever been given a Dx for House, but I have always been of the opinion that House has RSD (Reflex sympathetic dystrophy) I don’t believe amputation would help.
The whole time House was in that hole with Hanna I was sure there would be a collapse and he would be stuck too. Every time he went back in I was holding my breath.
Next season will be interesting to find out what happens. I’m thinking this is the preledue to the end though. 13 will be leaving, and House and Cuddy will be together but will discover they can either have a relationship or be collegues but not both, I guess someone will be leaving PP (House or Cuddy) Foreman will have his chance to run the department. As for Wilson, I don’t know marrige and divorce again…..
May 19th, 2010 at 8:35 am
Maybe, as previous post suggested, it was Cuddy trapped under concrete and subsequently died and that’s why House is so desperate considering OD’ing …… Could it be that it was Cameron assisting House underground and later in his flat convincing him not to take the drugs and that she still loves him????? therefore his mind playing tricks again this time swapping the people around???? …. only a thought.
May 19th, 2010 at 9:27 am
http://artsbeat.blogs.nytimes.com/2010/05/18/behind-the-plot-twists-of-the-house-season-finale/
Interesting discussion in the NY Times with writers of House. Enjoy! Love this site; far and away the best House discussions. And thanks to Scott for all his hard work.
May 19th, 2010 at 9:35 am
BTW, in the NY Times discussion, the writers indicate that what I thought was ludicrous (i.e. Cuddy’s breaking it off with Lucas during the episode) was in fact the case. I really hate that explanation! To me it makes less sense than her realizing much earlier that it would never work with Lucas, but heck, what do I know??
May 19th, 2010 at 10:59 am
I’ve been worried for two seasons that House and Cuddy would wind up together. …I see it as the end of House as we know him. Bad enough he stopped using narcotics for pain relief….now he is going to be in love and connected….not the House I enjoyed when I started watching. The writers are way off the mark if they think viewers want to see House as anything more than a brillant man who stuggles with lonliness, but does not have the capacity to change it.
May 19th, 2010 at 11:05 am
Cantare > About 13’s pregnancy… this would just be stupid. She suffered from losing her mother, and she knows very well how Huntington is transmitted, she would not risk a potential human’s life on a 50/50 odd, or even force it to lose its mother at an early age.
And to those who think there is something going on with her and Taub… come on, she is WAY out of his league! And not only physically, she had made it quite clear that she does not approve of his behaviour. They are friends, but there is no way they are involved.
May 19th, 2010 at 11:14 am
Dan> There is a big difference between being an ass, and becoming suicidal and self-destructive. His behaviour has changed, that much is certain. I had a House marathon the other day, and I watched the first series, and I was amazed at how his character behaved differently. He was blunt, but right, and he listened to people (even if that meant telling them afterwards how stupid they are) ; now he’s cruel. Remember the episode One Day One Room, or the one with the cancer kid… this is just impossible to imagine now.
Or even some random stuff, like when he plays poker with guys he meets regularly, or when he flirts with Leighton Meester, or the veggie girl.
The change came subtly, but it is obvious when you look back.
May 19th, 2010 at 11:59 am
I’ve noticed House was not using his stethoscope properly in the ambulance. Earpeaces are supposed to be pointed forwards, not beckwards considering the orientation of ear canal. And because of the the noise in the vehicle it would be highly recommendable.
May 19th, 2010 at 12:03 pm
I loved the episode, even if the end was convenient. I will say, a small part of me wanted him to self destruct completely. The way it ended almost made it seem like it should have been the series, not season finale.
As a side note, I had a lecture on traumatic injury today (I’m a med student) and I posed the scenerio from House to my attending. He said a patient has possibly 6 hours before ischemia is threatening, and that its possible that it could be much shorter than that (given the presence of rhabdo, other factors). He felt that amputation should follow when the urine turns brown-red (sign of myoglobinuria). Personally, I thought that would have been one of those cool House diagnosis scenes if he looked down and saw the woman was urinating brown/red and then decided to amputate. Anyway, just my two cents.
May 19th, 2010 at 1:09 pm
While House wasn’t having Vicodin-induced hallucinations, what about alcohol-induced hallucinations? He’s been hitting the bottle pretty hard the last several episodes …
May 19th, 2010 at 2:19 pm
this should of been the SERIES finale imo. what should of happened is one of two things:
a. relapse
b. he thinks about taking the pills and then says screw it and throws them away(good for him), but then maybe even turning to liquor afterwards as well
i guess they wanted us to actually see the relationship though and not have the series end once it actually starts. i have a feeling this will be the last season though.
May 19th, 2010 at 2:34 pm
NO hallucinations…this is directly from the writers in the NY Times article!
May 19th, 2010 at 2:50 pm
Enjoyable episode, appreciate the writers breaking out of some of their old routines.
But….agree with those who say the crane operator was a boring distraction. He mainly served to bring us back in the hospital to see that all was not well with 13.
Many commenters see the story line as though the characters were actually people, parsing their behavior and what they deserve in terms of what real people do. But they are characters in a story line. What happens with House and Cuddy next year has little to do with what would happen to real people and everything to do with what helps build TV scripts. I would think their relationship will have to be somewhat rocky simply because there would be too little drama–and humor–if things were working out happily ever after.
Understand that the writers were trying to build a changing character this season, but the price was too high. There was at least one previous episode–the methadone one–in which House realizes he needs his pain to be a sharp-minded doctor. Though I don’t necessarily agree with that conclusion, it appears that House cannot be a nice guy and still be the sharply witty character we enjoyed so much for the first four seasons. If the show loses its bite, loses its compelling patients and medical mysteries, it really has nothing more to offer than any other show.
By the way….despite their many other charms, Hugh Laurie and Lisa Edelstein make the worst on-screen kissers I have ever seen.
Scott, thank you for six terrific years. Reading your postings enhances the experience immensely. Look forward to seeing you in the fall.
May 19th, 2010 at 4:52 pm
Sir Mack wrote:
“Given the extent of his recovery I was surprised that he’d kept a hidden stash all season-long. (I will have to look back through earlier synopses as I seem to recall a scene early in the season where he discarded all his little stashes hidden throughout the apartment, making this seem like a contrivance, although I suppose the same could have been said of House finding a vial of Vicodin in the pocket of a trauma victim.)”
Since the Vicodin was well-hidden in a place not-at-all easy to get at, I assumed that House hid it there shortly after the resolution of the Tritter arc. As I recall, Tritter had searched House’s apartment and confiscated his entire stash. I imagine that House would have wanted to make sure that this never happened to him again, so he hid some away where no one would find it, and where he wouldn’t even be able to get to it easily himself — a real “emergency” stash. That’s why, even if he threw his little stashes away after his recovery, he might not have wanted to bother tearing the bathroom mirror off the wall. Plus, after his recovery, he was mostly staying with Wilson, and so the emergency stash wasn’t a temptation. Anyway, that’s the storyline I made up. It works for me.
May 19th, 2010 at 4:57 pm
I have a question for those who have read the NY Times article that ruthinor posted: It says “major spoilers ahead.” Do they just mean “major spoilers” for those who haven’t yet watched the season finale? Or do they mean “major spoilers” for next season? (Because if they mean the former, I’d love to read the article, but if they mean the latter, I don’t want to touch it.)
Thanks! And thanks, as always, to Scott for these great reviews!
May 19th, 2010 at 5:24 pm
@GreenMachine Yes I wasnt clear on that…but you are correct the EZ-IO is a EMt I/99 or EMT-P skill ….but hey I think it was the first time Ive ever seen a KED used on TV(kendrick extrication device)…I work in texas
May 19th, 2010 at 5:24 pm
InCP: The NY Times article only has spoilers from this season. The only thing mentioned about next season is the decision to not move ahead in time, but in the first episode, to focus more on what happens shortly after the last scene this season. Hope that helps. It’s a nice article and they also answer some questions from fans as well. Hope that helps..it’s funny too!
May 19th, 2010 at 5:25 pm
@Dan: Dude, you are absolutely correct. A lot of very good TV shows did tank after two major characters hooked up. That’s part of the reason why I’ve been so against House and Cuddy getting together. This was a great show, although the last two years have sucked overall, and it could have been great again. Oh, well.
@Dr. Bulgaria: You’re a romantic son-of-a-gun, aren’t you? I hope you at least sent flowers the day after you nailed your ex-colleague’s girlfriend. Or did she steal your wallet?
May 19th, 2010 at 5:28 pm
I somewhat agree about the kissing scenes, with the notable exception of last year’s finale. When they do passionate, I think they do it pretty well.
May 19th, 2010 at 6:42 pm
For those people who still think that Cuddy at the end was a hallucination, it’s not. Katie Jacobs, one of the House producers confirmed that it was legit in an interview after the show aired, so it’s real, and Cuddy was actually there. Jacobs also said that the two of them are going to give it a shot, at least for some time early next season.
As for the final scene itself, the way the show wrote itself, it was either House taking the vicodin, which would have put himself back in the same place as mid-season 5, except with Chase instead of Kutner; or someone coming to prevent him from doing so. Since Cuddy-House is an angle that hasn’t really been explored yet in the series, I figure this is as good a place as any to introduce it, since it certainly keeps us in suspense for next season.
May 19th, 2010 at 9:45 pm
happy dances aside….anyone who would actually dump the great person they’d been with for an extended period to get together with a boring, monstrously selfish, vicious, uncaring creep is a total moron unsuitable for either parenthood or status as an adult human being well able to care for themselves….that may seem a bit strong but frankly, let’s face it, the cure for the common asshole is to stay away from him. Saving such people isn’t “Love”. Accepting them as assholes and allowing them to behave as that to you in a romantic relationship is called being abused, not being loving. It’s time to put this foolishness to rest and deal with love as it is, not as some romance novel idiocy.
May 19th, 2010 at 10:23 pm
Watching House this season has felt more like a chore than entertainment. Instead of being caught up in the drama of the episode, I just kept rolling my eyes going, “Really? How much time is left?” This episode just seemed particularly forced.
As fire/EMS is my domain, I was “happy” to see that they got that about as right as anything else in the show. My safety officer alone would have had a heyday! (Don’t get me wrong, I assume that anything of a technical nature on any TV show is going to get butchered…) But did anyone else catch House doing the Johnny Gage imitation?
May 19th, 2010 at 11:11 pm
I think the girl dying, and Cuddy showing up at houses, was a direct result of his head injury, when the rubble shifted, and next season , she will not have died, and he will not have been kissed.
May 20th, 2010 at 7:38 am
House rules out cardiac tamponade because patient’s neck veins are flat but doesn’t pulmonary embolism also cause full neck veins?
May 20th, 2010 at 8:06 am
Not really a medical error, but there is absolutely no way the emergency crew would have let doctors without hardhats loose on the premises, especially to areas where they haven’t been to.
Not to mention letting House stay under the rubble without protective gear when they start with the airbags.
May 20th, 2010 at 1:15 pm
Anyone find it odd that Cuddy (not even a real doctor) was even at the disaster site?
Also, I wonder, Scott, if you know of any doctors who became administrators? Seems like monster waste of 100+ grand and 8 years of life, especially at age 30 or whenever Cuddy got promoted.
Yes. I hate Cuddy right now. I want season 7 to start with her gruesome death. I’m thinking axe murderer.
May 20th, 2010 at 1:34 pm
I’m sorry, but I think House is a dumb show. It is beyond far fetched and not always entertaining.
May 20th, 2010 at 3:53 pm
@gst: I was wondering if I was the only one bugged by the fact that House and Cuddy kept going down there without full turnout gear and helmets. Ridiculous!
I also HATED the end, no more eloquently than anyone else here.
I would’ve respected the show more had House taken the pills, or been hallucinating, or even let Foreman help him out.
I think this might be it for me watching House, but I’ll still come here to read all about it.
May 20th, 2010 at 5:10 pm
I think everyone that hated the ending are really idiots they are ignoring the fact that House and Cuddy have a years relationship and she cares deeply for him. She would not just leave him there to do drugs again.
May 20th, 2010 at 5:37 pm
A note about the acting on the part of China Shavers (Hannah): I have never seen such a convincing portrayal of acute pain on the small screen. The whimpering, the trembling, the breathing rate were all incredibly realistic. Yeah, we have all seen the screamers and moaners on HOUSE, but this was just believable.
Oh, and @Insurance Man, then watch something else. I think Ugly Betty is about to start. In the words of Gregory House, “you’re an idiot!”
May 20th, 2010 at 7:54 pm
RDMurphy
May 18th, 2010 at 1:57 pm
One thing I’ve always wondered, with a field amputation like that, how do you keep the patient from bleeding out before you get everything closed off?
I always wondered too!!! anyone please??
May 20th, 2010 at 8:37 pm
Cuddy _is_ a real doctor. An endocrinolog, if I remember correctly. And there were episodes with her doing a real medicine job.
May 20th, 2010 at 10:25 pm
@Bob
“The show seems to love that stab-in-the-chest treatment. They used it here, in the Antarctica episode, and at least one other time. Is “open pneumothorax” the same thing as I learned in first aid class to refer to as a “sucking chest wound” (more accurately, as the probable result of a sucking chest wound)? Because they never seem to address the idea that having a hole in your chest wall is generally considered to be a bad thing.”
A tension pneumothorax is life-threatening, especially in her already critical hypotensive condition. There is a check valve at the site of puncture which allows air in but does not allow air out. If the air doesn’t escape, than the right or left lung will continue to collapse and the patient’s work of breathing will increase to critical levels. The pressure that builds up on the lung will start to compress the mediastinum which will decrease cardiac output and decrease blood pressure further. She was already in pain and breathing shallowly. As well, the increased thoracic pressure will decrease venous return to the heart.
Better to have a hole in your chest well than dead. It’s kind of one of my personal mottos.
May 20th, 2010 at 10:42 pm
So, a Swine flu free season of House.
I liked the episode, surely because I can’t nitpick at the medicine so my focus is almost completely on the drama.
May 21st, 2010 at 4:12 am
@ rust:
I thought that the Hanna character looked familiar… China Shavers also played Brooke Harper on another Fox drama called Boston Public many moons ago along side Jeri Ryan (:p) & Chi McBride..
May 21st, 2010 at 4:43 am
About all those questions involving the amputation and the bleeding: They did not show that but I can assume that the emergency protocol would include compressing all the major vessels using bandage (we call it turniket in Bulgaria – not sure if this is a term a generic name or a russion word that settled in). The best place to bandage in cases like this is just above the knee – that is done for short periods of time to avoid tissue death. Of cours the second this is possible you have to remove the turniket and start suturing those vessels… thought this would not be done in an ambulance I think….
May 21st, 2010 at 4:56 am
Am I the only one to whom House strongly reminded of Gordon Freeman from Half-Life in the crane collapse scene, creeping through debris and using his cane as a crowbar?
May 21st, 2010 at 6:51 am
I HOPE the finale was someone’s hallucinatiom, otherwise this show is turning into Grey’s Anatomy. I thought House was against the grain and now I see the producers doing what the public expected and hoped for. What’s so wrong with being miserable? That was his depth of character, a part of his genius. I was disappointed by the Huddy moment. I have never liked Cuddy in the first place.