House Watch: The Spanish Fly Edition

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House is generally a self-destructive guy — the whole conceit of House M.D. is that he’s the sick but brilliant doctor who can heal everyone but himself. But last night we saw him injecting junk into his arm, so the stakes went up a notch.

Before the details, a spoiler alert: if you didn’t watch “The Fix” last night, knock back a Scotch and fire up the DVR before reading on. As usual, the diagnoses are in bold.

Two Patients last night: a woman who sells precision bombs to the military and a boxer who was defeated in a fight that House and Wilson attended. House lost a bet to Wilson on the fight, so of course he becomes convinced that the boxer, Foley, must be sick rather than just a poor athlete — despite the fact that the boxer has no apparent symptoms. House believes he can never be wrong—not even about boxing.

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The team is left to deal with the bomb maker, Dr. Wendy Lee, who presents with a seizure. House doesn’t seem that interested—he’s focused on Foley—and offers two wildly broad diagnoses: a tumor or a bleed in her central nervous system.

House finds a downcast Foley in a diner and tells him that the punch that knocked him out seemed to have barely touched him. Foley’s retort: “You ever been ‘barely touched’ by a guy who weighs 230 lbs.?” But House is adamant that the punch seemed light. He thinks Foley might have thrown the fight, but Foley points out that he was the 12-1 underdog—who would pay him to throw a fight that he was almost certainly going to lose?

But House thinks he sees something wrong with Foley’s pupils — an uneven dilation called anisocoria — and that this means his heart rate was abnormal during the fight — and that this means Foley has a heart problem called Wolff-Parkinson-White syndrome, a disorder in which the heart has a spare electrical pathway. (As usual, House seems to like this diagnosis because it’s exotic, not because he has much proof.)

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Back to Dr. Wendy Strangelove … Her boyfriend Cesar, also an arms dealer, stops House in the hallway to say he thinks he knows what’s wrong with her. Which occasions the first great line of the episode: “You screwed up in the lab and accidentally spilled some bomb on her?”

Cesar says maybe her ex — another coworker, Tony, who is apparently quite jealous — might somehow be responsible for her illness. Maybe poison? House doesn’t seem to care — he’s going to let the team deal with this one. He does tell them it seems Wendy is a “slut,” which of course riles 13, who doesn’t believe an adventuresome woman gets sick just because she’s adventuresome. It doesn’t help when Taub suggests Wendy has a severe urinary tract infection because of her “sexual escapades.” (They have tested her for every poison they could think of and ruled them all out.) When 13 gets offended again, Taub gets off a nice line: It’s not a UTI from her sexual escapades but a UTI from “her healthy enjoyment of her womanhood.”

Taub and Foreman search her house and find a big collection of old booze bottles. Alcoholism? But turns out they’re all vintage bottles that she says she merely collects. Another theory is that her severe stomach pain (a new symptom besides the seizure) is caused by the stress of having so many boyfriends. Which the team realizes is a pretty lame diagnosis.

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Meanwhile, in addition to pursuing the boxer and ignoring the Wendy Lee case, House has started to exercise his leg with a cord attached to his kitchen table. I don’t remember seeing him trying physical therapy before, so it was a little surprising. And then the real surprise: House takes out a white powder, heats it in a spoon, and injects himself with the bubbly residue. The fold of his arm shows lots of needle sticks. Has he upped the ante from Vicodin to heroin?

Later, 13 comes over—no one on House M.D. ever knocks on a door—and finds him shooting up. When he explains he’s taking an experimental drug that has been shown to help regrow muscle, 13 says the experiments have been done only in rats. Why would House use it? A beat passes. “Because it comes in banana flavor.”

At this point, the team is completely lost in the Lee case. Wendy is now bleeding from her vagina—could this episode focus any more on that particular part of her body? Foreman reaches for some overly broad diagnoses — “trauma”? — as well as hemorrhagic fever. They also think radiation poisoning, although Cesar insists their weapons company doesn’t work with radioactive material.

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And yet House is still MIA. He has run out of the experimental rat medicine, so he goes to the lab where it’s being used on the animals. When House meets the rat researcher, he tells the doc he needs to sit down because his leg hurts. And then House asks the researcher for coffee:

“How will coffee help your leg?”

House: “It will prevent me from walking to get the coffee.”

House then lifts a couple packets of the drug when the researcher is off getting the coffee.

The team is still foundering in the Lee case, and House can’t figure out what’s wrong with the boxer, if anything. He finally gives up and pays the money he owes Wilson over the fight. He isn’t a gracious loser–he even shatters the glass over that Vertigo poster that’s been in Wilson’s office for years. (I suppose it must feel like vertigo for House to be so lost on a case.) House goes to get drunk at a bar, and when the bartender says he won’t serve House any more, House gets off yet another good line (the writers outdid themselves for Huge Laurie in this episode): “[Serving alcohol is] the business you’re in. You’re in the screw-the-world business. You’re in the reality-sucks-and-fantasy-temporarily-appears-to-not-suck…”

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Both cases break in short order. The team becomes suspicious about Cesar’s adamant denials that his weapons company is using radiation. They confront him, and he admits he has been (final diagnosis) poisoning her — with Spanish fly (another highly sexual aspect of the episode). Cesar had been jealous over Wendy’s cheating. Somehow he had figured out that Spanish fly’s active ingredient, cantharidin, can be quite toxic. (It also engorged her genitals, which was a bit much. Wendy seems like a bitch, but I feel really bad for her vagina.)

And it turned out the boxer did have a rare condition, a (final diagnosis) glomus tumor in his neck, which — when he clenched his neck during the fight — shut his body down, allowing his opponent to knock him out with a weak punch.

At the end of the show, House’s leg does seem to be working better. But in the final scene, we see the rat researcher discover that one of his rats is dead, presumably from the experimental drug.

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It was a decent episode (my diagnosis: B), but I’m antsy for the finale. The main question is how the writers will deal with House’s continuing Vicodin use (at one point last night, he downed three at once). The writers will have a tricky task either getting him off drugs or having him continue to use. They have taken both paths before. It might take some experimental rat medicine to write their way out of it this time.

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Follow my health columns on Twitter @JohnAshleyCloud

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