It's a Wonderful Lie (House)

"It's a Wonderful Lie" is the tenth episode of the fourth season of House and the eightieth episode overall. It aired on January 29, 2008. It is the first episode of the series to feature Olivia Wilde, Kal Penn and Peter Jacobson as main cast members. The plot centers around the Christmas season; the episode's title is a play on the Christmas movie classic It's a Wonderful Life.

Plot

House and his team treat a woman, Maggie, who suffers from sudden paralysis of her hands. The paralysis presented as she was belaying and coaching her daughter, Jane, on the rock-climbing wall. The daughter falls and suffers a broken wrist. House probes the patient and her daughter, trying to tease out a lie between them, but both insist that they are always honest with each other. As the team tries to cure the paralysis, Maggie loses her eyesight, and her other organ systems begin to shut down.

Maggie is known to have inherited a mutation of the BRCA1 tumor suppressor gene from her mother, putting her at significantly greater risk of developing certain types of breast cancer. In an effort to avoid these risks, Maggie had an elective prophylactic double-mastectomy. She had no follow-up reconstructive surgery; this additional element of "honesty" further interests House, who despite it stands by his theory that everybody lies.

The team believes Maggie's symptoms might be psychological in origin, but this is proven false when she is discovered to have severe calcification of her entire skeleton, and the lymph nodes in her neck begin to swell and occlude her airway. House and the team conclude that her best hope is a bone marrow transplant, but she will not allow Jane to be tested for a match, despite Jane's protests. House concludes that the only reason someone would refuse that test is if they knew already that the marrow would not be an HLA match, not because "it might hurt a little". Maggie confesses that Jane is the biological child of a drug addict who made her promise never to tell Jane about her true background. House, satisfied that everyone does in fact lie, makes a snide remark about the irony of preferentially keeping promises to drug addicts. In the meantime, Jane goes to the lab to tell the doctors that she does not care what her mother thinks; she wants her bone marrow to be tested anyway.

Maggie is told she has an unknown terminal disease. When it is revealed to Jane that Maggie has a terminal disease, she tells her she won't live, despite her hopes of a wrong diagnosis. House later tells Wilson, "I saw something amazing. Pure truth. She told her mother that she was dying. Stripped her of all hope. It was like watching some bizarre astronomical event that you know you're never going to see again." Wilson says that House tells people the truth all the time. House says it's because he doesn't care, and that Jane told her non-biological mother the truth exactly because she cared.

The team, without House, spends the rest of Christmas Eve testing for every disease they can. While they are at work, House has a conversation with Wilson that leads to an epiphany. Entering the lab singing "God Rest Ye Merry, Gentlemen", House proclaims that he is about to perform a Christmas miracle, and orders his team to give Maggie risperidone, an anti-psychotic medication. At Maggie's bedside, House explains how, during fetal development, a layer of breast tissue progenitor cells develops. Eventually, the extra tissue dies everywhere except, as House puts it, in the "fun places". House suspects that this process was faulty in Maggie, leaving a deposit of breast tissue somewhere on her body which eventually produced a tumor. Due to the anti-psychotic medication, the tissue has engorged and begun to lactate; House extracts breast milk from the swelling found on the underside of the patient's right knee, orders her to have surgery and a round of chemotherapy, and declares the case solved.

In the clinic, House treats another female patient, called Melanie (Jennifer Hall), whom he initially diagnoses with strep throat. House notices that she has a necklace of Saint Nicholas, whom she describes as the patron saint of children. At the same time, he notices that she has had HIV tests every 3 months, and that Saint Nicholas is also the patron saint of prostitutes. Since she is not a child, he tells her that he has deduced that she is a prostitute, which causes her to smile in response. She later returns with pustules on her neck and chest. House asks if she does donkey shows, and when she says yes, he gives her a prescription for contagious ecthyma, a disease she has that can be caught from donkeys. She invites him to see the show, and says he might like it. At the end of the episode, House visits a church, which is putting on a Nativity play during which his clinic patient rides in on a donkey, playing the part of the Virgin Mary.

Reception

The episode attracted 22.56 million viewers in the United States, making it the 6th most-watched show of that week.^[1]

"It's a Wonderful Lie" received favorable reviews from critics. Donna Bowman of The A.V. Club gave the episode a "B" grade, stating "Although at times the episode was a more shameless Apple commercial than the frequent MacBook Air ads in the breaks -- two purloined laptops and an iPhone that House gushes over-- it does present House with an interesting variation on his usual misanthropy."^[2]

References