House lost a team member last night, and he didn’t save a life. A recap and the diagnoses are below, but first the standard spoiler alert: if you haven’t watched the episode, “Last Temptation,” order some chicken and fire up the DVR before reading on.
The episode focuses on Masters and whether she will become a surgeon or stay on House’s team. As the episode starts, she’s awakened to her 4:30 a.m. alarm and begins drilling herself on medical terms, including “differentials for swollen scrotum: hernia…torsion.”
It’s a funny bit, especially because the episode works hard to show how young and girlish Masters is — she’s even got multicolored paper airplanes hanging from her room’s ceiling. (My diagnosis: laying it on a bit thick.)
Today is Masters’ last day of school, but she needs to complete a 10th and final lumbar puncture before her procedure log can be turned in. But a fellow-student, an unctuous guy named Cruz, keeps doing the LPs in the ER himself, even though he’s done 14 already. (There’s a funny scene later in which Cruz asks Masters and her roommate Donovan out for a drink. “I’d love to,” Donovan says. A beat passes. “Except I think you’re a cretin.”)
Meanwhile, 13 is back. “What the hell happened to you?” Foreman asks. House lies that she’s been in drug rehab.
The case this week: Patient is a 16-year-old sailor, Kendall Pearson, who wants to be the youngest person to sail around the world. But she collapsed on her boat recently. Taub says that on a video of her collapse, it looks like she merely slipped at first. When she hit her back on the railing, she could have damaged her adrenal glands. His diagnosis: adrenal insufficiences caused her collapse.
Masters feels some kinship with Pearson because they were both prodigies: Masters went to college at 13. She knows Pearson wants to get started on her sailing trip as soon as possible, so she recommends they confirm the diagnosis quickly by giving the girl a stress test on a treadmill.
But during the test, Pearson’s hands turn blue. They put her on vasodilators — which open blood vessels — so that she won’t lose fingers. Foreman then offers his diagnosis: cerebral vasospasm, a narrowing of blood vessels in the brain.
The House-Wilson comic plot this week is the bet they have about who can keep a chicken at the hospital longer before security finds out. House tries to kill Wilson’s chicken by having a dog “fetch” it, but somehow — and this was uncharacteristically wimpy of the show — the chicken survives.
Still looking for an LP, Masters goes to the ER. She overhears 13 and House talking behind a hospital curtain. Masters discovers that 13 was not in rehab — thus confirming an absolute law of television medical dramas: secret information is almost always revealed by characters stupid enough to blab behind a thin ER curtain.
Masters wonders why anyone would pry. 13 has a wonderful answer: “House’s people have personalities that range from nosy to ‘Pardon me while I do this cavity search.’”
Masters asks 13 if she thinks there’s room for someone not so nosy. 13 answers no. But 13 does submit to an LP so that Masters can get her 10th. (13 gets LPs routinely because of her Huntington’s.)
Meantime, Foreman has a new diagnosis based on X-rays of Pearson’s cerebral midline: calcification of the pineal gland, which produces melatonin, the hormone released to help you sleep. (So wouldn’t the girl have trouble sleeping?) Rather stupidly, 13 says, “Case closed.” (Doesn’t she know the show is only half over?)
Because Masters completed her 10th LP, House cancels her internship — she knew he had already forged the approval in her log. He says he wants her to be able to compromise sometimes. She doesn’t want to cheat the system — but to House, the system is often the problem. One of the tropes of the show is a conviction that only by breaking the rules can you save the hardest cases.
Pearson has collapsed in the parking lot on her way home. Masters is assisting with a surgery — she’s now beginning her surgery internship — when she hears that Pearson is ill. She pretends she has to go to the bathroom so she can check in on her.
Pearson is having surgery — a sympathectomy, which will increase blood flow in her brain. Masters figures out the diagnosis that Taub used to order the surgery: “She must have had a hypertensive crisis caused by neural overstimulation of the kidneys!” Always the A student.
But Masters has lied to get out of the surgery she was assisting with. House mercilessly drives home the point that she’s beginning to understand the value of deception.
The episode gives Masters its A-Ha Moment, which is usually reserved for House. Masters sits up suddenly and cries: “Chickens!” She asks Pearson if she had ever gotten sick from eating poultry. Apparently her father gave her a can of pheasant as a joke a few months ago. Which is just bizarre: canned pheasant? If you find any, please let me know. Also, if it was a joke, why did she eat it?
When they do an MRI, they do find a problem in her humerus, but it’s not infection. It’s cancer. Final diagnosis: sarcoma. She will lose her arm.
But Pearson says she can still do her round-the-world adventure in a month and then have the arm amputated. Masters is horrified since the cancer could easily spread in a month and kill her. Pearson’s parents decide not to take her dream from her, so they approve her leaving.
Now beside herself, Masters goes to see House, who has a good line: “Pretty sure the law of the land states that everybody has the right to be an idiot. I think it’s the Second Amendment.”
House tells her she will have to break the rules.
“I can’t,” says Masters.
House: “So coloring inside the lines is more important to you than saving this girl’s life.”
Masters tries again to convince Pearson, but the girl is firm. She’s one of the best young sailors in the world. Going on the trip may not the smartest decision, but it’s hers to make. “At the top of the game, you play by different rules,” she says.
And so Masters breaks the rules. She gives Pearson a drug that forces her into cardiac arrest. She uses the emergency to get the parents to sign the consent form for the amputation. When the team learns of her deception, they don’t even say a word: they all play by House’s rules.
Masters tells Pearson after the amputation that the cancer had already spread to a lymph node in her neck, meaning she would have died on her trip — which may or may not be another lie.
But Masters can’t live with her decision, and she lies awake at night, ruminating. The next day, she tells House: “I manipulated, lied, forged, stole.” House more or less says that’s what it takes to save idiotic patients, but that Masters shouldn’t expect it to make her happy. How does she think he gets his “rosy demeanor”?
“You can’t always get what you want,” he says. Cue the song. (Which is a little hackneyed at this point — how many movies and shows have used that song to make an obvious point?)
House tells Masters that nothing will ever be simple again. She says she can’t stay at P-P — she doesn’t like what it will turn her into. (Also, the actress who’s playing her, Amber Tamblyn, is leaving for another show.) As Masters walks away, she stumbles over House’s chicken and smiles: she’s not chicken enough to become one of his lackeys.
So Masters is all grown up. I liked this episode a lot despite the lazy ending. My final diagnosis: A-.
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