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House: Ugly

House Episode 4-07C : Ugly

Airdate: November 13, 2007

This is a capsule review : it will be supplemented soon by a full review.

The Hook:

A railroad platform.. A train has just arrived and a father is talking to his son. They are interrupted by a young girl screaming : she's screaming at the teen-ager. His face is grossly disfigured : a growth on the left side of his forehead. The girl's father hushes her in embarrassment, and the boy and father talk some more while they are photographed by a film crew. The boy, whose name is Kenny, is surprisingly upbeat : he discusses having only 36 more hours before his surgery.

Chase preps for surgery, carrying on a running commentary for the film crew, who are apparently documentary film makers, and we see this scene, and many future scenes, in black and white through their camera. He's operating on a patient with "frontonasalencephalo.. something" and the operation will take ten hours. But the operation is over before it begins, as the assistant surgeons report that patient has heart problems which they rush to cope with as Chase yells for the camera to be turned off.

Cue freaky House music....


Act 1

Cuddy is being interviewed and explains the purpose of the operation to House and Chase comments, but it's all really for the documentary. The patient's heartbeat is now being regulated by a wire, and the operation is on hold until the cause of the heart irregularity can be found. "I became a doctor because of the movie Patch Adams," House mugs for the camera with all fake sincerity. (Actually, from what I've heard of Patch Adams : he did med schools at UNC Chapel Hill near here : he and House would make quite a pair. When Adams was ordered to come up with decorations for a symposium on OB/GYN, the visiting doctors found themselves entering the facility through a pair of spread legs complete with vagina-tunnel entry.) House tricks the film crew out of the room and confronts Cuddy. She apologizes for the distraction, but says the documentary folks are paying the cost of the surgery, so no film, no new face for Kenny.

House looks for diagnoses from the team, but they'd rather talk about the newcomer in the room (Hot Agent from last week). They want to know if she's taking one of their slots. House takes the group and camera crew for a walk, but ducks into the MRI lab where the crew can't follow. House asks for suggestions. Since Kenny has a midline anomaly in the head, they suggest possible midline anomaly in the heart, also. Or increased intercranial pressure (ICP). Or endocardial infection. Or IV drugs. Or, House suggests, from looking at the patient's nose, maybe he's huffing freon. House orders a nuclear study (MRI).

Alone with House, HA asks if his job offer was genuine : after all she gave up her CIA career. He assures her it was.

House talks with Wilson, worried HA might be an idiot and "I can't fire her, I just hired her." Wilson analyzes House's tendency to hire beautiful women, then fire them, then date them (or try to). He's impressed that House might actually be feeling a normal human emotion : guilt.

Kenny's dad protests his son has never huffed freon, but PSG tries to assure him of House's awesome diagnostic skillz.

Foreign Guy is preparing Kenny for the MRI. Kenny asks if his dad really think's he's doing drugs, and FG attempts, unconvincingly, to soothe his jitters. He babbles and asks the crew if they can edit his remarks "So I don't look like an idiot'" (Isn't that what the chairman of GM asked Roger Moore?) Kenny tells FG he's had headaches for all of his 16 years.

FG reports back to House, who is in scrubs along with PSG, that the MRI was negative for heart scarring from drugs. There's an operation in the background, but I think the only reason they're here is to get away from the film crew. PSG pushes for an LP ‘to test for infection' but House know it's really to test for ICP, PSG's preferred diagnosis. FG tries to get the information about the headaches in between House's deriding PSG for being an idiot.

The film crew complains to Cuddy about House ducking them.

House orders an EP study, dangerous because it mean stopping a heart that's already shown itself to be prone to stopping. Cuddy phones into the OR to ask House if he has a minute "to be disemboweled." Now that's an operation the staff would pay to watch.

PSG is explaining the EP study to Kenny, and conducts a little psychological manipulation to get Kenny to confess to doing drugs. Kenny reasons that if he confesses to drugs, they can go ahead and do the operation, so immediately confesses to every drug in the book, but it's unconvincing. He begins coughing through his ‘confession'. PSG says they're not doing the test. Kenny begins coughing up blood, and PSG calls for help intubating him.


Act 2

The team suggests more diagnosis. FG is wearing a tie. CB is wearing lipstick. House likes Big Love's suggestion of stomach cancer and sends him and PSG off to scope the stomach, but PSG is still holding out for ICP, and says that could lead to liver failure to explain the bleeding. But House says ICP can't affect the liver. House is starting to use names, so I guess I will have to soon, (you can always look them up at the end of this review) but I refuse until we learn who the still unnamed : even in the cast lists : 13 is.

Alone in the restroom, PSG explains to BL how ICP can cause liver failure, he but didn't say anything in front of House, because he didn't want to be made a fool of in front of all the potential viewers of the documentary.

PSG tells Kenny's dad they are in good hands, despite the danger, and the test begins.

Wilson tells the filmmakers that ‘it's great how he [House] rebounded from that setback". It involves toilet stalls and foot tapping, but "the records are sealed". Oh, and House is a wiccan. In comes House to chase the crew out. He worries some more with Wilson that he's losing it and tolerating HA for her hotness, and not her medical skills. House gets paged - Kenny is vomiting blood again.

Back to the diagnosis room. The EP shows it wasn't stomach cancer, and Kenny's liver is failing. PSG pushes for ICP again, but House points out symptoms not present and asks for new ideas. The group seems reluctant to suggest anything and House berates the film crew for making his protégés reluctant to diagnose. HA breaks the silence suggesting auto-immune disease. House uses Foreman to shoot that one down, not trusting his own judgment where hotness is involved. 13 suggests mitochondrial disorder. House again doesn't trust his judgment coming from another pretty face and has FG repeat the same suggestion. Since it still seems like a possibility, he sends CB to go look for signs of retinal degeneration. PSG still speaks up for ICP, so House sends him with CB.

The film crew interviews Cameron in front of a patient who's reluctant to be on camera. They tell him they'll blur him out. The patient comes up with the idea to make the film unusable by swearing, but the crew ignores him and his swearing attempts are laughable. The crew asks Cameron if House treated her as bad as he treats the new guys. Cameron says casually that "I love Dr. House", then stammers trying to make it that she loves learning from House.

CB is trying to use a standard machine to examine Kenny's retina, but his enormous forehead deformity prevents it, and PSG says he'll do it the old fashioned way, with flashlight. What, no head mirror?

PSG reports to House - no degeneration, but swelling (from that ICP). House says the swelling just comes from the deformity, not ICP. He suggests a better guess is Juvenal Rheumatoid Arthritis, JRA, treatable with steroids. Which, PSG says, will mess with his immune system and delay the surgery for months. PSG says he'll speak to the father, seemingly caving in to House.

He explains the diagnosis to Kenny's father, but then explains that he thinks House is wrong and that he thinks he can get House thrown off the case and get Kenny his surgery.


Act 3

PSG makes his case to Cuddy. House fires him. Cuddy say's PSG was ‘over the line' and sends him from the room, but says he's not fired... yet. House says he's going to treat the patient without his knowing, but Cuddy says to do a CT scan of the kid's head to confirm the JRA diagnosis. House warns her "If we have to start getting consent before doing a procedure, soon they'll be asking for informed consent."

Foreman and PSG do the CT scan.

House ‘interviews' with PSG's old firm, supposedly seeking medical help, and asks them what made PSG leave. They avoid the question.

PSG tried to deliver the CT results, but House users him into Cuddy's presence first. Both point to the scan film and argue it proves their case. House confronts PSG about his reasons for leaving his last plastic surgery practice, and reveals he's also talked to PSG's wife, who gave a different reason from the firm. PSG ducks into an examining room to get away from the film crew, but they follow him anyway until a doctor doing a pelvic exam orders them all out. The crew leaves, but House and PSG stay. The patient objects to this but PSG explains "we're doctors". Oh , OK then. PSG is concerned about what House may have revealed to his wife. PSG reveals that he had an affair with a nurse, his partners found out and forced him to resign. "Some people pop pain pills, I cheat. We all have our vices." Touché.

Out in the hall, Cuddy who's been examining the scan, says she doesn't see the evidence for ICP. PSG is to stay away from the patient's family, House is to stay away from PSG's family.

House strides into the patient's room. "Wow! You are ugly." "Wow, you are an ass," Kenny responds. Right in one. Kenny's dad doesn't trust House's opinion. Basically because House doesn't seem to care, while PSG did. But Kenny breaks in to reveal how badly he needs to be cured, because no one treats him as normal, not even his dad. House seems touched, and tells him to take his steroids, then he can have his surgery. But, he warns "It will only change your face. It won't change who your face made you."

House, with Wilson, breaks into the Records Room with keys from ‘Lou the janitor'. They review the tapes and Wilson critiques HA's diagnostic technique. Wilson seems more interested in her bust line. And 13's as well. House is dismayed that he's been distracted by a pretty face. "I can't believe I'm that guy." "All guys are that guy," Wilson observes.

Cameron practices how to clean up her earlier Freudian slip. She's doing it in front of Chase. Seeing this close-up I'm thinking the blonde dye job was a bad choice for her. Chase say's "That's great, clears everything up." He's lying. I admire him for it.

PSG is earnestly entreating House to reconsider his diagnosis, showing him shadows on the CT scan film. "You're right, I didn't see that before," House says and leads him to...

The patient's room, where he points out the obvious improvement in Kenny's condition from the steroids. PSG concedes that he's wrong. Kenny jokes with PSG, but House looks concerned : he's noticed a tremor in Kenny's little finger that contradicts his diagnosis. Back to square one : cancel the surgery.


Act 4

House is back with the diagnostic crew. Still looking. 13 pipes up suggesting Lyme's disease. Explains everything, including why Kenny got better on steroids, she says. House points out one glaring lack : of a "huge, target-shaped rash," so it can't be Lyme's. PSG accuses House of refusing to concede that he's cleared the kid because he (House) want to stop the surgery : since House is not normal, he reasons, House doesn't want anyone else to be normal, either. CB suggest rheumatic fever. PSG suggests removing Kenny's pacing wire : if he's really cured his heart will work on its own. Of course if he's not, his heart will stop. House tells FG to man the paddles on standby : "another chance to blow someone up."

PSG is briefing father and patient on what to expect as the wire is removed. Dad is doubtful, Kenny's ready to go. The wires are extracted. Kenny's heart remains stable. All smiles, and the patient heads for the OR under the camera's unblinking gaze.

House, disgruntled, ponders his White Board o' Symptoms.

We're back to where we started, with Chase and another surgeon briefing the film crew. 13 is there, but not part of the OR team. She says she still doesn't think the kid is cured. She's looking over Chase's shoulder at pictures of the patient. She asks when they were taken.. "Three weeks ago", Chase says. She's noticed changes in the discoloration of the patient's skin around his hairline : bordering the big cyst.

House and Wilson are in House's office, House seemingly practicing how to fire HA. Wilson uses the opportunity for more House psychoanalyzing. 13 breaks into the room to tell House he was right about Kenny not being cured, but wrong about it being JRS : it's Lyme's. "The target-rash is hiding," she says, "no one ever looked at him close enough."

Off to the OR where the rash is revealed hiding under Kenny's hair.

House philosophizes to the film crew, but his answers are not responsive to their questions.

Back together with the team, House has a new nickname for PSG telling him "Mini-Stud, stand up." (Does he need a blindfold for this?) House has done a little more detective work, and found that PSG signed a non-compete with his old firm : that's why he can't look for a job in plastic surgery. "So you gave up your chosen career, just so they'd be quiet?" "I love my wife." "You risked this job, with nothing to fall back on?" ""I thought you were wrong." Now there's something House can respect. PSG stays. Soooo.... it's HA that gets fired. House asks her for a date. She leaves without speaking.

Cuddy and House review the finished film. They've cut it to make House a saint. "The horror," he exclaims. Cuddy is all smiles. She mock-cries at how moved she is. House stalks off "I owe it to the world to make sure this evil never sees the light of day." Cuddy watches the final scene of a post-surgery Kenny thanking Dr. House. Now the tears are genuine.

- Cecil

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Next week: House treats a magician. With a mysterious illness. (Aren't they all?) Cuddy's thong is somehow involved. "The most outrageous episode of the season." House collapses.

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Non-Episode News: Sources on the net say there are six episodes in the can as of the beginning of the writers' strike. Assuming that includes this week's show, that's five to go : January is looking a bit bleak, absent a quick resolution.
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Prev. Episode: 4-06 "Whatever It Takes" - 11/06/07
Next Episode: 4-08 "You Don't Want to Know" - 11/20/07

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Guest Cast Ep. 4-07, "Ugly" Aired 11/13/2007

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Originally aired: Tuesday November 13, 2007 on FOX

Director.............................David Straiton
Writer:..............................Sean Whitesell

Show Stars:

Hugh Laurie.....................Dr. Gregory House
Lisa Edelstein...................Dr. Lisa Cuddy
Robert Sean Leonard........Dr. James Wilson

Omar Epps........................Dr. Eric Foreman
Jennifer Morrison.............Dr. Allison Cameron
Jesse Spencer...................Dr. Robert Chase


Recurring Roles:

Bobbin Bergstrom............Nurse
Michael Michele..............Samira Terzi / Hot Agent / HA from last week
Anne Dudek....................Amber / Cutthroat Bitch
Edi Gathegi......................Cole / Black Mormon / Big Love / BL
Peter Jacobson..................Taub / Plastic Surgeon Guy
Kal Penn...........................Kutner / Foreign Guy
Olivia Wilde.....................Thirteen / 13

Guest Stars:

Khleo Thomas....................Kenny / the patient
Troy Vincent......................the Father
Laurie Fortier.....................Darnell / Documentary maker
Michael Whaley.................Joe / Documentary maker
Mandy Schneider...............Pretty Woman / Jenny / Documentary maker
Adam Pilver.......................Cranio Surgeon
Michael Adler....................bashful E.R. Patient
David Campbell (II)...........Plastic Surgeon
David Um Nakase..............Physician


Posted by Cecil on November 15, 2007 10:02 PM
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