It's a Wonderful Lie (House)

House (TV series) episode
episode_name= It's A Wonderful Lie
episode_no= HOU-410
airdate= January 29, 2008
writer=
director=
guest_star= Janel Moloney (Maggie)
Liana Liberato (Jane)


season= 4
diagnosis = Breast cancer in displaced breast tissue

"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.

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, the woman loses her eyesight, and her other organ systems begin to shut down.

The patient is known to have inherited a mutation of the BRCA1 tumor suppressor gene from her grandmother, putting her at significantly greater risk of developing certain types of breast cancer. In an effort to avoid these risks, the patient 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 that the patient's symptoms may 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 the patient will not allow her daughter to be tested for a match, despite the daughter'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". The patient confesses that her daughter is the biological child of a drug addict who made her promise never to tell the girl 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, and encourages her to tell her daughter the truth.

The patient is eventually told she has an unknown terminal disease and the team, without House, spends the rest of Christmas Eve testing for every disease they can. While they're 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 the patient an anti-psychotic medication. At the patient's bedside, House explains how, during fetal development, a layer of breast tissue progenitor cells develops on the entire surface of the body. Eventually, the extra tissue dies everywhere except, as House puts it, in the "fun places". House suspects that this culling process was faulty in the patient, 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's had HIV tests every 3 months, and that Saint Nicholas is also the patron saint of prostitutes. Since she isn't a child, he tells her that he's 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 (an atheist) 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.

Cultural References

* House says that one of the Christmas gifts his fellows gave him was a second edition Conan Doyle, which is a reference to Arthur Conan Doyle, author of the Sherlock Holmes books. House's character is inspired by Sherlock Holmes. House makes a further reference to Holmes when he paraphrases his quote "I never make exceptions. An exception disproves the rule" (from "The Sign of the Four").

* After Thirteen gives House the "vintage LP" the beginning of "Sun King" by The Beatles is played in the background. It is a cover that uses Christmas bells to give the song a Christmas touch. This also implies that the "vintage LP" House is given is The Beatles' "Abbey Road".

* House repeats a quote from the episode "Whatever It Takes" in which he in another way says: "This is gonna be a tough case. I have almost no knowledge about alien physiology"

* House says "Have a wonderful life," this is once again a reference to the movie "It's a Wonderful Life".

* Saint Nicholas is also the Saint of the falsely accused, along with prostitutes, and children, making the ending scene of this episode all the more appropriate.

Reviews

* [http://firefox.org/news/articles/1127/1/Review-House-MD--quotIt039s-a-Wonderful-Liequot/Page1.html Review: House MD--"It's a Wonderful Lie"] from Firefox News
* [http://www.tvsquad.com/2008/01/30/house-its-a-wonderful-lie/ House: It's a Wonderful Lie] from TV Squad
* [http://politedissent.com/archives/1889 Medical review of "It's a Wonderful Lie"]