House S07EP23 “Moving On”
And now we’ve hit the end of the season for House this year, with the final episode again bringing us a medical mystery that is intended to reflect House himself. The episode starts off with Cuddy and Wilson giving police statements indicating that House has done something awful, and we quickly transition to “Three Days Earlier.” House is recuperating from his impromptu leg surgery from last week, and introduces a new case to the team. A performance artist, Safoun Hamidi is about to have herself lit on fire when she collapses in front of her audience. She exhibits multiple signs and symptoms including heart arrhythmia and abnormal hematocrit, which then expand to include growing rheumatoid symptoms as she is hospitalized.
The final diagnosis is Wegener’s granulomatosis, an autoimmune disease of about 1 in 100,000 incidence in the United States. It is one of a number of inflammatory vasculitis disorders, and typically presents in patients in middle age with variable and non-specific symptoms. This variability can make diagnosis difficult, but the standard for diagnosis is the identification of antibodies reactive against neutrophil cytoplasmic antigens (ANCA). The treatment is immunosuppressants to diminish the antibody response, plus radiation therapy to treat a mass on the brainstem. She refuses this treatment, as she cannot bear the thought of the associated cognitive diminishment the treatment would cause. Refusing radiation treatment would ultimately be fatal to her, even with steroids to treat the Wegener’s. House of course applauds this stance, as it reflects his approach to the muscle infarction that led to the damage in his leg. In the end though, Hamidi’s assistant convinces her that life is more important and she decides to go through with radiation therapy. House aggressively disagrees with this decision, and goes on to leave New Jersey for a sunny beach. He does make a stop on the way.
The episode concludes unlike many season finales, giving us the end of a story arc with no real cliffhanger that we’ve seen in past seasons. The big news from the show over the past few weeks, and I doubt that the writers had time to include this into the season finale, is that Lisa Edelstein recently announced that she will not be returning as Cuddy in the Fall season. Although the character of Cuddy could be an excellent foil for the antics of House, helping to ground the character, she really hasn’t been given sufficient screen time prior to this season to convincingly do this. To solve this lack of screen time, the writers introduced the House/Cuddy relationship at the start of this season. This unfortunately eliminated her objectivity towards House, which was demonstrated more than once over the second half of this season.
As a result, House (the series) has used a plotting device called “The Reset Button.” Consider the first season: we had a brilliant doctor with a drug problem, who solves all of the mysteries no one else can solve. He has a team of underlings to do his bidding, and supporting characters who come in and out of the episode. Two of the underlings are the same ones as at the start of the series. Things after 7 years do not seem to be noticeably different. House has been in trouble with the drug use over the intervening years, spending time in jail and detox, with no real behavioral changes. Has he changed as a character? Well, maybe driving a car into Cuddy’s dining room will be an effective way of coping with the pain in his life, but I have my doubts. I think we will be back in the fall with House again solving the mysteries no one else can, and being entertained in the process.