“Lines in the Sand” is one of those beautiful House episodes that fits together like a jigsaw puzzle, with the overall picture right there in the title.

Ten-year-old Adam is the patient of the week, and the episode opens with some nifty direction and effects to give us his autistic point of view. His weary parents have even more to stress over when he starts choking and screaming. It’s probably not a happy time for him, either.

That part’s not funny. The rest of the episode is, with House at his theatrical best, spouting witty remarks and pop culture references, facing a litany of stupid clinic complaints with a look of utter desolation on his face, and even talking in couplets, though not quite the kind that would make Shakespeare proud: “Go up his rear and get a smear.”

As usual, best line reading of the night goes to Hugh Laurie, in a small voice after trying and failing to get all Dog Day Afternoon on Cuddy: “Attica?”

House is rebelling against her horrifically cruel decision to replace the blood-stained carpet in his office, and he refuses to work in there until she relents and puts the old one back.

“You think you can get me to do anything you want no matter how stupid it is?” she asks, thinking – not unreasonably – that it’s one of House’s games. He plays along by doing the differential diagnosis meetings in the clinic, in Wilson’s office (where he plays with one of those Zen sandboxes – CLUE!), in an office Cuddy had booked for her own meeting.

The TV guide description makes the connection between the case and House explicit for us, though the episode lets the connection build slowly. Oh well, at least the show treats its audience like they have a brain, even if the marketing department doesn’t. Though Cameron’s first guess is that the carpet obsession is a power play, she starts to wonder if House’s actions aren’t just a little autistic. Wilson eventually reveals to Cuddy that House’s unusual connection with the boy is rooted in his belief that House might have Asperger’s syndrome, a mild form of autism that makes people socially inept and uncomfortable with any change in routine. Wilson believes House is trying to help himself through the kid, but dismisses it as an actual diagnosis:

“You’re not autistic. You don’t even have Asperger’s. You wish you did. It would exempt you from the rules. Give you freedom. Absolve you of responsibility. Let you date 17-year-olds. But most important, it would mean that you’re not just a jerk.”

Yes, one of those lines in the sand House would like to cross is the jailbait/only-inappropriate-age-difference line, since his teen flirtation, Ali, is back this episode, trying to convince him that the line between 17 and 18 is arbitrary and meaningless. She has definitely crossed the line into stalkerdom, but House’s withering putdowns seem to wither in the face of 17-year-old breasts.

Cuddy points out the girl called 15 times, which is not quite normal:

Cuddy: Your mother’s not that interested in you.

House: Maybe I’d be better adjusted if she was. …

Cuddy: She’s dangerous.

House: She’s not dangerous.

Cuddy: She’s pretty.

House: She’s pretty.

Cuddy: Men are stupid.

House: I’m with you so far.

So he knows it’s stupid, but he’s having fun, and House is all about the fun. Except when he’s about the misery and the crushing of hope and the solving of puzzles.

This time, the puzzle fits together through a collection of symptoms that, of course, don’t add up – because if they did, this would be the shortest episode ever.

Foreman, the neurologist, starts out with a solid theoretical understanding of autism that makes him dismissive of any other explanation than simply that. He then demonstrates a complete lack of practical understanding of autism when he ignores the parents’ warnings and take the kid’s electronic game away from him in order to do the MRI House requests. Having learned his lesson the hard way, he sweet-talks Wilson into doing the subsequent lymph node biopsy, forgetting to mention the patient’s tendency to writhe and scream.

That gives House the opportunity to connect with the kid while actually being in the same room with him. He demonstrates the anesthesia mask on himself in order to get Adam to follow his lead – and leading to a hilariously dopey and flirty House in the next couple of scenes.

He dismisses the parents’ hopes that their son has made a human connection with a curt “Monkey see monkey do. Your kid is just as messed up as when we admitted him.”

The crucial piece of the emotional puzzle is filled in afterwards, when House explains his connection with the kid in his own terms to a pitying Cameron:

“See, skinny, socially privileged white people get to draw this neat little circle, and everyone inside the circle is normal and anyone outside the circle should be beaten, broken and reset so they can be brought into the circle. Failing that, they should be institutionalized or, worse, pitied. … Why would you feel sorry for someone who gets to opt out of the inane courteous formalities which are utterly meaningless insincere and therefore degrading. … Can you imagine how liberating it would be to live a life free of all the mind numbing social niceties? I don’t pity this kid, I envy him.”

Wow. Can you imagine a House who is living free of all the mind numbing social niceties? Now that would be a cable show.

When Adam’s case eventually starts to look like poisoning, House explains in unsentimental terms why the parents might be driven to poison their own child. “They are everything you’d want in a parent. Unfortunately, their kid is nothing you’d want. When a baby is born, it’s perfect. Little fingers, little toes, plump, perfect, pink and brimming with unbridled potential. Then it’s downhill. Some hills steeper than others.”

It’s a nice tie to last season’s “Daddy’s Boy,” where we discover that House keenly feels his parents’ disappointment in him, and confides that in Cameron. Here, he’s both more and less revealing, since afterwards he dismisses her with: “My parents love me unconditionally. Get out of here.”

When the usual suspects – the parents – seem to shockingly not be poisoning their child, House realizes the kid might have eaten something poisonous by accident. So he tries to get Adam to communicate by choosing from pictures of things in the back yard, including a Polaroid of the weed they suspect.

This is where the title was a detriment to the story, because when Adam’s hand wavered over the images, I realized it must be the sandbox. I thought House got that, too, especially when Adam actually picked the sand. So the next scene, where House hilariously preaches to his diagnostic disciples in the chapel, confused me a little, until I cleverly realized he hadn’t been quite that clever. Someone should have told him the title of the episode.

House is finally convinced to speak to Ali to crush her crush, so he goes into melodramatic Casablanca mode – “the problems of two people don’t add up to a hill of beans” – and she eats it up, crying for her noble lost love until her milky tears become a clue. House realizes that she’s infected with spores that are affecting her brain. It’s a mirror image of a senior citizen clinic patient from season one, Georgia, who fell in love with House due to syphilis.

While he’s moping over that – and, maybe, the case – a glimpse of the squiggly lines Adam had been drawing clue House in to the final piece of the puzzle. Worms in the sand Adam ate have been causing his symptoms. After he’s cured, House watches the family being discharged.

“First tongue kiss, an 8 on the happiness scale. Child being snatched back from the brink of death, that’s a 10. They’re clocking in at a very tepid 6.5 because they know what they have to go back to,” he tells Wilson.

But then, as Wilson points out, they hit a 10 when Adam thanks House in his own way, by handing over his game and making eye contact.

The guy who can’t see the value in Wilson’s keepsakes from former patients can not only see the enormity of Adam’s gesture, it’s the perfect language between the game-obsessed, socially withdrawn boy and the game-obsessed, socially withdrawn man. He can’t dismiss the wordless thanks the way he did the parents’ effusive thanks, and maybe – but probably not – sees that hope is not, after all, futile.

Still, it’s obviously a blow to the poor man’s ego that he was a symptom rather than a cause of Ali’s condition, but at least he’s still got Cameron. She watches with him as his old, blood-stained carpet is reinstalled – Cuddy finally relented, after facing the fact that House is just that screwed up – and gazes at her boss meaningfully. “All change is bad? It’s not true, you know.”

“Lines in the Sand” was either a great way to enter the baseball hiatus on a high note, or a mean way to enter the baseball hiatus by making us wait with even more anticipation for the next one.

House returns on Tuesday, Oct. 31. I’m uncomfortable with the change in routine.

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