TV Review: House, M.D. – “The Mistake”

(Warning: spoilers for the episode that aired Nov. 29)

This week’s House opens with a feisty mom soothing her daughters’ nerves before their big talent show number, when they are upset at rich Sally Ayersman’s snooty remarks about their costumes. “If Sally’s mean to you again, I’m just going to have to key her daddy’s new convertible,” mom Kayla says with hilarious near-foreshadowing.

When we see her popping painkillers in the audience as her precious kids take the stage and massacre “Itty Bitty Pretty One,” it’s almost a funny moment – except that the CGI shots of her oozing gut tell us it’s really not very funny at all.

This set up provides the introduction to a very non-formulaic episode structure, as “The Mistake” unfolds with hospital lawyer Stacy (Sela Ward) preparing mistake-maker Chase (Jesse Spencer) and his boss House (Hugh Laurie) for a peer review following the patient’s death, and we see their alternate and sometimes opposing versions of past events.

Despite that definite article “the”, there are a few mistakes referenced in “The Mistake.” The most obvious is Chase’s that led to Kayla’s misdiagnosis and eventual death, and this is the mistake that Stacy is determined to find a mitigating reason for, but Chase and House are determined to leave unexplained.

Instead of a bleeding ulcer, Chase diagnoses Kayla with Behcet’s disease, leading to a cascading chain of medical woes when the undetected ulcer perforates. His “little” mistake is in not asking her any questions when she comes to the clinic for her test results, despite her mentioning continuing pain – but as House says, paraphrasing himself in other episodes, “Mistakes are as serious as the results they cause.”

She eventually needs a liver transplant, which she gets thanks to her brother and a blackmailed lab tech who hides the fact that little brother Sam has Hepatitis C, and thanks to House and a blackmailed transplant surgeon, a Dr. Ayersman, whose new convertible does wind up getting keyed (though not by Kayla). Prize for best line reading of the week goes, of course, to Hugh Laurie, for the priceless “Are you free?” after he lays out his plan to ruin the doctor’s marriage – and halve his income – if he doesn’t perform the risky surgery. Though the surgery goes well, unfortunately, the Hep C had also caused liver cancer, which was treatable in Sam but led to immunocompromised Kayla’s death.

We get pieces of the puzzle doled out slowly in flashbacks, then retracted and replayed differently as Stacy realizes her narrators are unreliable. She starts the episode trying to avoid House, whom she hasn’t forgiven for stealing her therapy files and manipulating her into nearly revealing her desire to be with him instead of her husband.

“40% of our lawsuits last year were about House. If you can’t work with him, you can’t work here,” Cuddy (Lisa Edelstein) admonishes the reluctant Stacy. (Later, in another case of a small detail being picked up for humour, House says: “I’m not the one being sued. I feel funny.”)

House’s past manipulation is another mistake. Sort of. “You’re mad at me for letting you know what I did, because you liked where things were going,” says House, in a sincere apology with the Housian twist of not quite being sorry for the right thing. “And for that I actually am sorry. It was stupid.”

The structure isn’t just clever, it’s fun, too, with House occasionally stepping out of a flashback scene to interact with Stacy in the present. We get the pleasure of being able to piece together the mystery of the episode without needing to follow the medical twists and turns – though they’re not as baffling as some, they’re also not really the point. The cancer diagnosis is the “aha” medical moment, and it’s another flash of brilliant House deduction that even Stacy seems to admire. But the real “aha” moment is the revelation of why Chase made the mistake.

When they learn that in addition to the peer review, Chase and the hospital are being slapped with a huge lawsuit from Kayla’s brother, Chase finally reveals that recently, when he found out the family couldn’t afford to keep Kayla’s house after her death, he goaded the brother into suing by saying he had been hungover when Kayla came to the clinic for her test results. Just when we think the mystery might be solved (though a little unsatisfyingly), House takes Chase privately to the new Balcony of the Second Season Budget Increase to prod him to tell the truth: Kayla’s clinic visit had interrupted a phone call that informed Chase of his dad’s death – a mitigating factor for his distraction.

When Chase asks how House knew, he starts off with the smart alecky response: “There’s this interconnected network of computers, or Interweb, where you can …” before admitting that when dad visited, he told House he only had two months to live, and “when you screwed up, I did the math.”

Finally, and just a week after I expressed my bloodthirsty desire for the writers to kill off Chase’s dad, they did, and in a way that says he’s been appropriately dead all this time and we just didn’t know it. Sly writers. Since the episode would have been filmed long before that review, I can’t claim any credit for the plot turn. Oh, plus the fact that I have absolutely no clout. (I do have a slight grudge against them for messing with my detail-oriented [see also: obsessive; picky] mind by changing Dad’s three months to live in last season’s “Cursed” with two months to live here.)

It was a beautifully played scene, with Chase’s pain and indignation that House had kept his dad’s illness from him, and House’s compassion hidden in brutality and frustration that Chase would throw his career away rather than tell the committee. Throughout the episode, we had seen House fighting to save Kayla through unethical, desperate means, and suddenly there’s another possible motive, other than his usual ends-justify-the-means tactics on behalf of his patients – he’s fighting for Chase’s job, too, and continuing to respect the uncharacteristically noble choice he made months ago to stay out of Chase’s relationship with his dad.

Chase’s trials also reflect something about House, when he admits to Stacy at the end that he is the one who can’t figure out how to work with her when he still has feelings for her. “I don’t want to end up like Chase. I don’t want to get emotionally caught up and kill … you,” he finishes semi-lightheartedly. They’re left realizing the difficulty of working together, admitting their not-completely-negative feelings, but no closer to a resolution.

Chase does decide to reveal the cause of his distraction to the committee and gets off with minor punishment, but House is held accountable for his reluctance to see patients. In a final scene that makes up for in humour and a promising set up what it lacks in plausibility, Cuddy is ordered to have another doctor supervise House for at least a month. She assigns the employee who has been his most frequent challenger, Foreman (Omar Epps), to the role. While Foreman and House exchange evil glances, Wilson (Robert Sean Leonard) nods at Foreman and closes with the best last word of any episode so far: “Guess I’m his best friend now.”

(House is pre-empted next week on Fox, but should return Dec. 13 with a new episode.)

(Cross posted to Blogcritics)

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