House Divided


"House Divided" is the twenty-second episode of the fifth season of House. It aired on April 27, 2009.

Plot

House lies in his bed, unable to sleep and being haunted by hallucinations of Amber. His pager goes off, and he heads to the hospital where his team is reviewing Seth Miller's case. Seth is a student who became deaf from meningitis at age four. During a high school wrestling match, Seth "hears" an explosion before collapsing. House hallucinates about Amber in his office, where she comments about "the limp leading the blind". Amber, representing House's subconscious, tells him hints that he would not otherwise notice to help him "put things together". Amber tells House the patient's C-reactive protein was slightly elevated and that the stress of the seizure lab triggered the blindness. Amber then advises House to play music — Public Enemy's "Fight the Power" — for Seth, which helps him uncover a new symptom, neuropathy.
House tosses out his bottle of sleeping pills because he needs Amber's help. The team quizzes House about how he diagnosed the neuropathy. House claims he assumed that Seth's losing match record meant his balance was off due to diminished sensation. House wonders if the deafness was caused by NF2 cancer so he orders a brain MRI. Taub speaks to Seth's mother about the NF2 cancer and the possibility of him regaining his hearing. Seth, however, insists on remaining deaf.
Taub shows House the MRI results and says there is no tumor in the brain, so Thirteen suggests a biopsy. Amber tells House to do a comparison of slides from when Seth broke his nose years ago. House goes into Wilson's office while Wilson's talking to Chase about the bachelor party House is planning for him. House has the two MRIs with him, and shows them to Wilson, who confirms that there is evidence of NF2 in the scans and that a brain biopsy is needed. House and Amber watch the biopsy from the gallery. Chase tells House that the biopsy shows nerve inflammation, not cancer. Amber pushes House to have Chase insert a cochlear implant into Seth, which causes him to freak out once he discovers it. His mother demands the removal of the implant. As a result, Foreman now leads the group, and the team discusses Seth's post-operation fever. Taub wonders if Seth's girlfriend gave him the Epstein-Barr virus. Foreman has the team treat the virus with ribavirin.
House drops by Wilson's office to discover why Wilson has not criticized him over the cochlear implant. Although the implant was unethical and illegal, Wilson said that House did a kind thing. When Taub enters the room where Seth and his mother are arguing about his implant, liquid spills off the bed and onto the floor. The team discusses the urination symptom while eating liquor-flavored ice cream that House brought to sample for the bachelor party. House and Amber recover a memory that leads to House realizing that a rapid heartbeat can release a hormone that causes the body to release sodium.
The EKG test the team runs is normal, but Amber says the heart is not fine. House responds that the arrhythmia is hiding and that they will need to stress-test Seth. Foreman disagrees and tells Taub to run a thyroid panel. Amber and House conspire to stress Seth with asthma medicine. House enters the patient room to find him being restrained by nurses. Seth had ripped out his implant. Amid the chaos, House and Amber find the arrhythmia on the graph of Seth's heartbeat. Seth is restrained in his bed, his blood pressure low. Foreman admits that House was right about the heart. Thirteen recommends that Seth's blood pressure could be the result of thrombocythemia. Foreman orders a VQ scan of the lungs.
Meanwhile, House sends Foreman and Thirteen to a strip club where they evaluate strippers for Chase's bachelor party. Foreman tells Thirteen that he believes House is organizing the party to split up Chase and Cameron. Wilson warns Chase about the consequences of House throwing Chase's bachelor party. From the gallery watching Seth's biopsy, Amber recommends House to get the same stripper he got for Wilson's bachelor party years ago, Karamel. Chase comes to House to tell him that Cameron will not be happy with the party, so House will have to kidnap him.
House and Amber are in the morgue, where House practices lighting shots of alcohol with a flaming bottle for the upcoming bachelor party. House accidentally sets a cadaver on fire, resulting in him adding "chemical burns" to the cadaver's Cause of Death. House considers Amber's idea that the symptoms are from heat, caused by Uhthoff's phenomenon. House calls Foreman to tell him the diagnosis of multiple sclerosis.
Cameron, Chase, and Foreman are on their way out of the hospital for the night when two "immigration officers" approach Chase. They have come to take him in for a visa violation. Chase plays along, and Cameron tells Foreman, "Don't let House get him into too much trouble." During the bachelor party, which takes place in Wilson's apartment, House performs his flaming shot trick for Chase and the party crowd cheers. Wilson walks in, surprised to find his apartment taken over. Karamel, the stripper from Wilson's bachelor party, approaches Wilson and soon he is doing shots off her stomach. House is drinking in the bathtub with Amber. Inside the party, it is Chase's turn to do a body shot off of Karamel when suddenly he passes out. Chase falls into anaphylactic shock from the strawberry-flavored body butter on Karamel. House realizes that he knew Chase was allergic to strawberries, and wonders if Amber did this on purpose. Suddenly, he gets a call from the hospital: Seth is dying.
Chase is brought to the ER by ambulance with the team and met by Cameron. Cuddy is holding a chest x-ray, showing them Seth's lung failure, who is now on a ventilator. Meanwhile, House arrives drunk at his apartment. House realizes Amber is having a negative impact on his life: She had attempted to murder Chase. Amber tells him to go to the hospital, but he wants to sleep.
At the hospital Taub, Thirteen, and Foreman are hooked up to IV bags to sober them up. Cuddy calls House for his diagnostic help. Amber suggests eosinophilic pneumonitis to House. Foreman and Thirteen agree that they need to see if Seth's voice is hoarse to diagnose it. They take out Seth's breathing tube to test him, but they find that he chewed tobacco. Foreman explains that the tobacco released toxins that suppressed his immune system. When Seth stopped chewing, the lack of toxins brought out sarcoidosis. They start Seth on treatment. Seth's condition improves, and, despite his protests, his mother decides to implant the cochlear device in him again.
House comes to Cuddy's office to get sleeping pills, admitting he has not slept through the night since Kutner killed himself. The next day, House awakes from a proper sleep, thinking he has gotten rid of Amber, but finds her right beside him.

Music

Response by Deaf and hard-of-hearing fans regarding "House Divided" was largely negative. Criticisms focused on the ongoing theme undermining the Deaf culture by stating Deafness should be 'corrected' regardless of individual beliefs and portraying positive responses for a culturally Deaf adult/adolescent who underwent surgical implantation after expressing his wishes to remain Deaf. Complexities of cochlear implant surgery or auditory response to cochlear implants are not acknowledged in this episode, particularly in the portrayal of what Seth would hear upon waking as a teenager newly implanted without preparation. Additional criticisms include the mother serving as interpreter for all appointments rather than a nationally certified American Sign Language interpreter. In reality this causes miscommunication and creates ethical issues regarding the mother's conflict of interest; the unauthorized implantation of a cochlear implant device and frequent implications that Deaf people who elect not to be implanted are intellectually inferior and incapable of having a culture.