Thursday, June 01, 2006

Smoke if you got 'em -- Episode 105, "Damned If You Do"

Clinic patients:
The last Santa you'd want to sit on

This episode pretty much hinges on trust. For the nun, it's trusting that House didn't screw up and give her too much epinephrine. For Santa, it's trusting that House isn't out of his mind in prescribing cigarettes for an inflammatory bowel. It's hard to say whether we're ever supposed to doubt House the way Cuddy and his team did. But I didn't give a second thought to House pushing the cancer sticks, so why should I do the same with the nun?

The scene with Santa on its own is persuasive enough. House prescribes the cigarettes only after all other options had failed; he has studies to back him up; and he sort of mitigates the threat of addiction by making the dose only one two times a day, "no more, no less." A later scene with Foreman -- though really about the idea of putting the nun in a hyperbaric chamber -- underscores that House was probably fully aware of the risk of prescribing cigarettes but that he weighed it against the benefit. Foreman sarcastically asks House if he remembers the Hippocratic Oath. "First do no harm," he snidely responds, later adding: "Every treatment has its dangers."

But again, this is with good ol' St. Nick. Whether House screwed up with the epinephrine is still on the table -- even to House. A key scene to that effect actually begins with a discussion of the cigarette prescription, after Wilson walks in on House rifling through the clinic drawers.

House: "OK, yeah. I'd like to clear my reputation."
Wilson: "Oh, right. I forgot how much you care about what people think. Prescribing cigarettes for inflammatory bowel? That uh ... they can cause cancer, you know."
House: "Do you know why they have ribbons for breast cancer, colorectal cancer, prostate cancer, but not for lung cancer?"
Wilson: "They ... ran out of colors?"
House: "It's because people blame lung cancer patients. They smoked, they screwed up, they deserve to die. The reason people die from lung cancer is guilt."
Wilson: "Huh. Well, guilt does a lot of damage."
House: "You said that with great significance."
Wilson: "You're not here to find your stethoscope. You're not here to clear your reputation. You're here because you're having doubts. You might have screwed up."
House: "I'm here because if I'm right, Cuddy is killing that patient."
Wilson: "OK. But if you're wrong?"
House: "Then she's saving her."

It's when House starts to doubt himself that we start to doubt him. And he was pretty damn sure of himself with Santa.

Speaking of nuns (which, you know, we weren't), this one started in the clinic. And you can't get much closer than a main case with a patient who started in the clinic. Remarkably, even though it's only the fifth episode, she's not the first to be used that way -- Dan, the lacrosse player in "Paternity," technically started out as a clinic patient. The difference is that the nun was introduced in the clinic, which is where she had the formulaic pre-credits breakdown (Dan's was on the field, if you'll recall). So what we have here is a variation on a theme, and one I might explore in a later post.



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