Well, that wasn’t what I was expecting.

House the show, like House the character, is a master of misdirection, and this episode was full of many tantalizing examples. Even knowing all was not what it appeared, the episode left me admiring the show’s ability to piece together this heartbreaking, infuriating character I’d like to kiss and then stab. Kind of like Cameron.

A media release ruined the first bit of misdirection by revealing that House wasn’t talking to another hospital as a job candidate, but as a patient for a brain cancer clinical trial.

Because it seemed an unlikely direction for the show to take, and because I’m a big baby who can only handle one life-threatening event against House each year, I basically took advantage of our interview to get Katie Jacobs, executive producer and first-time director of this episode, to reassure me that it couldn’t possibly be cancer without exactly telling me that it couldn’t possibly be cancer, because I don’t like spoilers.

So watching Cameron, Chase, Foreman and Cuddy unravel the mystery behind House’s flight to Boston, I figured something else was going on. I just didn’t expect the ultimate answer to reveal such a brazenly unsympathetic side of House while still managing to managing to elicit my sympathy for the miserable, messed-up bastard that he is.

In stark contrast to the complex title hero, the simple patient of the week in “Half-Wit” is musical savant Patrick Obyedkov, played with a profound sweetness by musician Dave Matthews. Patrick is brought to the hospital after his hand freezes up during a concert, and the diagnostic team is brought in largely because House is curious about how Patrick’s brain works rather than about the cause of his hand dystonia.

“Half-Wit” was full of delicious witticisms, but as someone who loves making up my own words, I was particularly fond of the line: “Just because it’s inexplicted doesn’t mean it’s inexplicable.”

Kurtwood Smith of That 70s Show is very un-Red-like as Patrick’s father, a somewhat stern but always loving presence who surprisingly doesn’t harbour an alternate identity as the stage father from hell who is somehow at the root of his son’s medical issues.

He does act as interpreter, informing an auditorium full of people (and therefore, no coincidence, us) about his son’s accident 25 years earlier that left him brain damaged but a sudden musical prodigy, and informing House and Foreman (and therefore, no coincidence, us) about Patrick’s coping mechanism of mimicry, because he knows he’s expected to respond to people, but can’t always grasp how.

House has found a fun, new toy in the person of Patrick, getting him to mimic the opening bars of “I Don’t Like Mondays” (subtitle in House’s mind: “Or Anything or Anyone Else”), then to continue a song House had begun composing in junior high school but had never been able to complete.

“He’s fine. Can he go?” Foreman asks. “He’s great. He’s staying.” responds House.

The camera panning from Hugh Laurie’s hands to his face – look, it’s really him! – reminded me of the fun clip on the FOX website where modest Laurie praises Matthews’ musicianship, but Matthews the guitarist and vocalist gets the definitive word on who’s the better pianist: “I had a hand double, whereas Hugh did not.”

Watching doctor and savant play piano together, with House’s grizzled features next to Patrick’s child-like openness, makes them seem like polar opposites, but the episode uses that connection between them to further explore a couple of favourite themes of the show.

House is almost jealous of his patient. Patrick has something House would dearly love to have, something you couldn’t say about most people. If you discount the fact that most people have two pain-free, fully functional legs, that is.

The one thing Patrick can do in life is play the piano, but he has nothing else, not even the ability to button his own shirt. Unlike House, he has no other choice, nothing he’s deliberately sacrificing in order to maintain that one thing.

The one thing House has is his medical brilliance, and he has no qualms about pushing people away, or abusing drugs, or forgetting to button his shirt, as long as he can focus on a case and do his job.

But House’s one thing is dangerously close to becoming drug seeking rather than solving medical puzzles. And his drive to treat his patients at any cost is close to morphing into treating himself at any cost, after his temptation in “Insensitive” to harvest his CIPA patient’s spinal nerve, and his actions here to take a spot in a clinical trial away from a terminal cancer patient so he can get the good drugs.

In an attempt to see the music, House puts Patrick in an MRI machine. House tells his patient to pretend his leg’s a piano, and has to insist when Patrick objects that his leg is not, in fact, a piano.

“Kid’s a moron,” House says to Foreman, and I’m clinging to the fact that Laurie’s purposely over-the-top delivery is why I am not a horrible person for laughing so hard.

The MRI shows us that, as House says later, music is a global phenomenon when it comes to the brain’s hemispheres, and Patrick’s racing heart tells the doctors that his hand issues might be tied to a heart problem.

House has a heart problem of his own – it’s in hiding. When his team snoops and deduces their way into the conclusion that he’s chasing another job, Cuddy goes for the confirmation and instead discovers that he’s a brain cancer patient. Lisa Edelstein beautifully conveys her anguish at finding out House’s apparent medical condition.

She also gets a later scene beautifully mixing a little poignancy with a lot of snap, when she lets him grab some ass while enjoying a hug. But “call the Make a Wish Foundation” she says when he starts following her into the bedroom.

That’s the start of the parade of proof that the people House annoys every day care about him. Wilson confronts House and is rebuffed, Foreman tries to express his grudging affection for his boss and is rebuffed, and Cameron … well, Cameron isn’t rebuffed.

She demonstrates just how much she’s learned from working with House. She takes his “I love you, thanks for the HIV test swab” trick from “Need to Know” and makes it so much more. She starts off with a “newfound nonchalance in the face of cancer,” getting House to sign a reference letter she’s kindly written for herself, then getting all big eyed and moist-eyed before stepping in for a kiss – a kiss he doesn’t step away from, then returns with some gusto – before pulling out a syringe so she can get a little blood as part of the team’s campaign to find an answer besides one year to live.

I don’t want to see House hook up with any main cast members, and if I had to pick one relationship to back, my vote would go to the snarky sparks with Cuddy. But that kiss? Was hot. As was the devious motivation behind it. Another century or so under his tutelage and Cameron just might start popping Vicodin like candy.

And House liked it, too, however much he wants to brush it off with: “I didn’t want you to die without knowing the feeling. No woman should die without knowing the feeling.” And: “You need a sperm sample, come back without the syringe.”

Though he won’t give her the blood sample, he does tell her how to access his medical records: in a nod to General Hospital, soap-loving House has used the name Luke N. Laura for his medical files.

The team, shocked to find that the clinical trial is to treat depression in terminally ill cancer patients, drive themselves haggard pouring over the records, searching for hope, for alternate treatments.

They also continue to try to express their affection for their affection-allergic boss. Foreman ineptly tells him he likes him, which House doesn’t buy for a second. He seems to forget that it’s not impossible to be both annoyed by someone and like them at the same time – though you’d think Wilson would be ample proof of that.

Chase is more effective, in a scene both hilarious and touching.

Chase: Do you have to do that?

House: You mean cheapen everyone’s attempt at a human moment by identifying the real calculations that go into it?

Chase: Yeah.

Chase presses on, though: “I’m sorry you’re dying. I’m going to hug you, OK?” It’s sincere, and simple, and he doesn’t even take any blood samples. House doesn’t know what to make of it.

After his colleagues decided he was dying, House finds himself in the position of being able to see how much they care, and to abuse them for caring. Win-win for House. It’s almost a game to him, to see how they attack his medical files, and see the parade of concerned faces knocking at his office door.

Through it all, there is no hidden angst behind Hugh Laurie’s performance, no sign of actual depression from a man who’s shown signs of it frequently enough before. So the spectre of him having a year to live, or needing the clinical trial for depression, seemed puzzlingly unlikely. But then how would House react to his impending death? It’s quite possible with just that much sang-froid. There were enough hints throughout the episode that there was something wrong with the scenario deduced by the team to keep up the tension, and enough doubt to make me wonder what exactly I was being directed away from.

House has better social skills when dealing with Patrick, sort of. He manages to engage him and make a connection that involves something more than parroting, which gives their exchange of “Do you like your life?” “What life?” a shadow that might otherwise be dismissed as Patrick simply not understanding the question.

There’s a cute scene where House teaches Patrick some bad words – I almost wish the show were on cable, so they could have really had fun with it – and teases him about girls. Patrick says he doesn’t like girls. Or boys. “I like piano.”

Though House is annoyed at people making deductions about him, he’s still in Sherlock Holmes mode about his team’s private life himself. He seems to have already picked up on the Cameron-Chase fling, accusing them of showering together, and it doesn’t take much for him to trace the gossip line from Wilson to Cameron to Chase.

The friends with benefits arrangement seems to be working well so far and adds some fun tension to the proceedings, like when they use their newfound teamwork to break in to House’s apartment – Chase the ever-stylish wearing a wearing fluorescent orange trucker hat as camouflage – and Cameron dodging the question of whether she’s been there before.

This episode seems particularly jam-packed with detail. I believe it’s the first time we haven’t had the full credits sequence, though it was a nice touch to end on a jarring piano note before heading into the post-teaser commercials. The line abused by the promotions people – Wilson imploring Cameron “You can’t tell ANYONE” – was cut. Still, I’m glad they found time for a shot of House’s high school yearbook with a familiar-to-Hugh-Laurie-fans shot of his young unsmiling face. (The nice detail is that he still has his yearbook around – wow, is it possible that I’m less sentimental than House?)

The volume of quips, character moments, fun and angst did mean that I felt the full weight of the decision House presented to Dr. Obyedkov wasn’t given quite as much time to breathe as I would have liked. Though Patrick ends up having two treatable conditions, House is convinced that removing the right hemisphere of his brain would not only eliminate the need for anti-seizure medication, it would allow the left half of his brain to function at a higher level.

In advocating for the procedure to Patrick’s dad, House dismisses his musical gift: “He’s the monkey grinder at the circus.” Which is both harsh and not entirely untrue, like a lot of the horrible things that come out of House’s mouth. He also forces Dr. Obyedkov (I wish they’d given him a first name so I didn’t have to keep checking the spelling of that) to examine whether he’s thinking of Patrick’s happiness or his own gratification.

“I’m offering him a life,” House says, ironically something House doesn’t really have himself.

Dr. Obyedkov tries to discern from his son what the best decision might be.

Dad: Are you happy?

Patrick: Are you happy?

The scene is wonderfully ambiguous. Is the father’s decision to proceed with the hemispherectomy because of his son’s limitations, limitations that mean he can’t grasp the meaning of what it means to be happy, so simply mimics his father? Or is he answering the son’s question? As in, no, I’m not really happy to button your shirt every day of your life so you can do the one thing you’re capable of. Either way, it’s not a selfish act – he’s attempting to give his son a life, and maybe in the process, give himself one, too.

It was a rare House where I could eat dinner while watching … until we got to the place where they took chunks of brain out of Patrick’s skull. Afterwards, House and Patrick’s father wonder how much he’ll recover, then watch as he buttons his shirt by himself, something we saw him fail to do in the teaser.

“He looks happy,” House remarks.

Though I didn’t think Patrick looked miserable before, it’s impossible to think Patrick’s father made the wrong decision, since the other option was just as much of a compromise – to preserve his musical abilities at the expense of his ability to live a more normal life.

Would House take that trade? His one thing for a shot of normalcy? We have our answer from “No Reason.” He has taken it. It failed. And there’s the root of my sympathy, even when my face was just as horrified as his minions to realize the medical records they’d been pouring over, the medical records House used to get into the clinical trial, belong to a patient at the hospital.

One bit of irony in the episode is that House’s team solved a medical mystery that House didn’t even realize was a mystery. The patient does not have cancer and is going to be fine. House is less than thrilled to discover he’s been “cured,” leading him to admit that it wasn’t his file, and he wanted in on the trial because they’d inject a drug directly into the pleasure centre of his brain.

“You faked cancer to get high?” Cameron asks, aghast, as we see the shocked and disappointed faces of the three of them. Chase has to be looking like quite a catch to her now.

House had to know there would have to be an end game strategy. At some point, he’d have to explain why he wasn’t dead yet. But that could wait until he got that great new drug. However, the team had sent the happy results to the Boston hospital, so House wasn’t getting on that plane in the morning.

Later, Wilson confronts him to clarify the inner workings of House’s brain, as is his lot in life.

Wilson: How depressed are you?

House: I’m not depressed.

Wilson: You faked cancer!

House: It was an outpatient procedure. I was curious.

Wilson claims depression in terminal cancer patients isn’t that common, not in people with friend and family, anyway. It’s not the dying that gets to people, it’s the dying alone that does. So he points out the irony: “You don’t have cancer. You do have people who give a crap. You fake cancer, then push the people who care away.”

“Because they’re boring,” is House’s reply.

“Half-Wit” was written by Lawrence Kaplow, who seems to think he’s moving on at the end of this season. Hmm, and I seem to think I have anything to say about that. It echoes some of the themes of season two’s “Distractions,” which Kaplow also wrote, and which showed us the lengths House would go to in order to avoid dealing with unpleasant emotions – now, even boredom falls under that – and how his drug use is tied to that. And again in “Half-Wit,” Wilson pleads with House to take up a non-self-destructive pastime, like going for pizza with a friend.

The episode ends on the kind of shocking scene the promotions people wouldn’t think was nearly dramatic enough to deserve that word. “Next, on the most shocking House yet: he thinks about joining people for dinner!” Passing by a restaurant, House sees his minions gathered together, pauses, and reaches for the door handle. While more cynical viewers could imagine him changing his mind, just the impulse to reach for the handle is a buttoning-his-own-shirt step for House. I imagine him joining them, insulting them all, ruining their friendly dinner, but also, secretly thrilling them all with the knowledge that he’s willingly there.

OK, maybe I am sentimental. So I’ll refrain from calling FOX any names related to the episode title for forcing us to wait until March 27 for another new episode.

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