Control is the fourteenth episode of the first season of House, M.D.. Like 1x11 - Detox and 1x09 - DNR, this episode represents a break from the formula laid down in the David Shore-scripted/Bryan Singer-directed episodes, 1x01- Pilot and 1x03- Occam's Razor. Yet Control goes one step further. In all of the previous episodes, the patient's case had been the focal point. Even in Detox- with its subplot of House's Vicodin addiction- and DNR- with House's battle with more traditional doctor- the diagnosis had taken up the majority of the runtime. The mystery presented in the opening minutes went unsolved until well into the third act. Here, House makes the correct diagnosis in the beginning of the second act. The majority of the episode concerns itself with House risking his career for his patient, the tension building between him and his staff (particularly Chase, although an important subplot involving Cameron begins), and the start of the five-episode Edward Vogler subplot. This is a shift in focus away from a medical equivalent to CSI or Law & Order and towards a character portrait of Dr. Gregory House. In subsequent episodes continuing into the second season, the diagnosis is sometimes the focus of the episode, sometimes a MacGuffin to advance House's story. This extraordinary episode is thus a landmark in the series as much for itself as for the doors it opens for later high water marks, such as 1x21- Three Stories and 2x08- The Mistake.
Successful career woman Carly Forlano experiences paralysis in her leg and is referred to House and his team. Meanwhile, billionaire donor Edward Vogler, who wants to cure deadly diseases, becomes the new chairman of the board at the hospital and takes an instant disliking for House. Foreman almost discharges Carly, but her pain worsens. House has Wilson search for cancer, but Carly refuses embarrassing tests, so Wilson offers less invasive ones, which turn up negative. When Chase makes a mistake because he is flirting with the nurse Jenny, House chews him out. During the retest, Carly goes into respiratory arrest. House examines her psychological symptoms and realizes she is bulimic. To get a heart transplant, he lies to the committee about the bulimia. As Carly gets her heart, Chase- wounded from the tongue-lashing and suspicious of House's uncharacteristic silence- finds evidence of Carly's bulimia. After Carly's recovery, Vogler presents House with the evidence and orders House to shape up or accept consequences to the people who care about him.
- Ricky Van Der Meer: A young boy who comes to the clinic for a cough. House is intrigued by his father, who was struck mute after knee surgery. When Mr. Van Der Meer returns to find out his son is okay, House injects him with a mysterious serum. On Mr. Van Der Meer's third visit, House reveals the drug he injected was Botox to treat a rare condition caused by intubating surgery patients. Van Der Meer refuses to acknowledge House's treatment worked, because he is afraid he will have to give back the malpractice settlement he won for the injury, but House gets him to admit that the treatment was successful.
(See the Medical Dictionary for all definitions.)
- House presents Carly Forlano's case to his staff as "paralysis and severe pain in her right quad." Cameron hypothesizes a clot. Although Foreman hypothesizes a disk herniation, Cameron manipulates him and Chase into agreeing with her. House nonetheless orders blood thinners and an angiogram to prove Cameron wrong. He also orders an MRI and biopsy to find the real problem.
- Edward Vogler tells the board the story of his father, who had Alzheimer's disease.
- When Carly's pain worsens, Chase says the tests turned up "no neurogenic or myopathic abnormalities." Foreman rules out trichinosis, toxoplasmosis and polyarteritis nodosa. Cameron believes the sedimentation rate could be misleading. House agrees to investigate whether or not Carly has cancer.
- As Wilson and House discuss Carly's potential cancer, Wilson warns it would be tricky, but House says, "That's why I'm talking to an oncologist." They argue over Edward Vogler, and Wilson warns "there's not much money in curing African sleeping sickness."
- House begins his conversation with Dr. Simpson by saying the new chairman is causing him to consider a specialty change to orthopedics. House then asks Simpson about the surgery on Mr. Van Der Meer's ACL, which caused his muteness. House asks if Van Der Meer might have had cortical disease, such as Wernicke's, but Simpson says he did not.
- When Wilson first comes to visit Carly, she knows he is a cancer doctor, because the other Wilson in the hospital is in ophthalmology, and, "My eyes are fine." Wilson suggests she have a colonoscopy to look for colon cancer, but she is embarrassed by that. Wilson then recommends a "virtual colonoscopy" with a CT scan.
- When Van Der Meer returns to the clinic, House assures him Ricky has strep throat.
- House notices Chase's angiogram is of the wrong leg, and a resident signed the radiology report.
- After Carly's respiratory arrest, Cameron says Foreman's thoracentesis drained fluid from her lungs."
- When House talks with Wilson about Carly's need for a transplant, Wilson asks if the thoracentesis fluids revealed a transudate, but House says he has not received the results. Wilson asks about the ejection fraction on the MUGA scan, but House says he has not done that test, either. When Cameron and Chase arrive with the thoracentesis results, Cameron says an echo also confirms the need for a transplant.
- House tells Carly Forlano he knows she has bulimia. He says the ipecac which induces vomiting is causing her heart damage.
- House discusses Carly's case with the transplant committee. "Pressors and vasodilators have not improved her condition whatsoever," he says. "Pulmonary function tests show an FVC of over three liters with FEV-1 of at least 90% of predicted, and preserved FEV/FEC ratio and preserved DLCO as well. Her MUGA had an ejection ratio of 19% with no focal wall motion abnormalities. Heart catheterization revealed clean left, right and circumflex arteries, and subsequent biopsy revealed irreversible cardiomyopathy, which is why we're here." Cuddy asks about exclusion criteria. House answers, "CAT scan revealed no tumors, and Dr. Wilson found no trace of cancer. ... No atherosclerotic vascular disease, ... no pneumonia, no bacteremia, no hep B or C or any other letters, ... no alcohol, no drugs." Cuddy asks about psychiatric conditions, but House lies and says he found none.
- House tells Van Der Meer he "treated this spastic dysphonia with Botox."
- After Carly's transplant, House gives her fried chicken to "get you started" on the strict diet given to her by the cardiologist.
- "Baba O'Riley" by The Who: House listens to this on his iPod as Vogler comes to confront him with the bulimia evidence. Also later, House leaves the hospital.
- "Hava Nagila" by Klezmer-Fiesta: House tries to end his conversation by starting up "Baba O'Riley" again, but this plays from his iPod instead.
- Edward Vogler becomes chairman of the board at Princeton-Plainsboro Teaching Hospital.
- House and Cameron: Cameron asks House if he likes her, implying that she is asking if he is interested in her romantically. House takes a long pause before he says, "No." Although House has said in 1x01- Pilot he finds Cameron beautiful. In 1x12- Sports Medicine, they went on what could be considered a date, but this is a major step forward in the development of their sexual relationship.
- House and Cuddy: As Cuddy defends House, Vogler asks if she is now or if has ever slept with House. She does not answer but calls the question "inappropriate." Excluding House's facetious remarks, this is the first reference to Cuddy and House having a possible sexual relationship. More details of their past relationship will be revealed in subsequent episodes.
- House and Vogler: House begins his rivalry with Vogler. Vogler is annoyed by House's lack of respect for authority and the financial drain of his department, as well as his willingness to lie to the committee. House is dismissive, but Vogler threatens to fire Cuddy or Wilson.
- Chase and Vogler: Vogler confronts House with evidence of Carly Forlano's bulimia and claims a nurse brought the evidence to him, although Chase had also found it. This is the first indication that Chase and Vogler may be working together.
- 1x07- Fidelity: During House and Wilson's argument, Wilson says, "There's not much money in curing African sleeping sickness," a reference to the disease House diagnosed and treated in that episode.
- First Appearance: This is the first appearance of Edward Vogler. It explains how he comes to be chairman of the board at Princeton-Plainsboro Teaching Hospital and why he dislikes House.
- Real Time: Vogler says House treats "one patient a week." This is the first reference in the series to the possibility that House episodes occur more or less in real time- in other words, that an episode which airs on March 15, 2005 takes place on or about March 15, 2005, and the succeeding episode would take place on March 22, 2005. The entire conversation is also a sly reference to the tagline for the series: "Every week a new mystery... every week a new baffling case that only one team can solve." Although this and future episodes seem to continue the real timeline hinted at here, previous episodes had no such restriction. (See 1x06- The Socratic Method.)
Behind the Scenes
- 24 Connection: Sarah Clarke plays Carly Forlano, the bulimic woman whose life House risks his career to save. Clarke also appeared on the FOX series 24 as Nina Myers, a CTU agent suspected of being a terrorist mole. Clarke is the second 24 Season One cast member to appear in this season of House, M.D., after Leslie Hope, who appeared in 1x10- Histories as House's main patient. A third recurring cast member from that series' first season, Currie Graham, would be House's patient in 1x22- Honeymoon, and he would have a recurring role in Season Two.
- Crew Name Homage: Clinic patient Mr. Van Der Meer's name is an homage to Gerrit Van Der Meer, the unit production manager of the series.
Allusions and References
- Negotiating Books: When Cameron manipulates Foreman and Chase into agreeing with her, House accuses her of reading "one of those negotiating books." He lists examples:
- Getting to Yes: Getting to Yes: How to Negotiate Agreement Without Giving In is a bestselling self-help book by Roger Fisher and William Ury. It describes methods for negotiation and persuasion.
- How to Win an Argument: House says, Fifty Ways to Win an Argument. Although there is no book with this title, this is most likely a reference to the bestseller How to Win an Argument: Surefire Strategies for Getting Your Point Across by Michael A. Gilbert.
- The Hitchhiker's Guide to the Galaxy: House's title Hitchhiker's Guide to Being a Pal is a reference to the comic science-fiction novel The Hitchhiker's Guide to the Galaxy by Douglas Adams, about an Earthling who is dragged into a cosmic journey with a companion who is an editor of the eponymous bestselling travel guide.
- Gilligan's Island: Cameron is optimistic about Edward Vogler's position as the new chairman of the board. Foreman asks, "Do you ever watch Gilligan's Island reruns and really, really think they're gonna get off the island this time?" Gilligan's Island was a 1960s sitcom on CBS about a group of shipwreck survivors washed up on a tropical island. Most episodes involved The Professor devising a scheme to get the group off the island, only to be foiled by the bumblings of the first mate Gilligan.
- Scary Movies: House claims to have seen "every scary movie ever made" and mentions two things which are "bad omens." These are references to actual horror films:
- The Shining: "Six-year-old twins in front of an elevator" is a reference to The Shining, a 1980 film about a haunted hotel, written and directed by Stanley Kubrick and based on the novel by Stephen King.
- The Omen: "Boys' choirs" is a reference to the 1976 film about the birth of the Antichrist, The Omen, directed by Richard Donner.
- Sarah McLachlan: As House confronts Carly about her bulimia, he says her cutting herself is "probably highly ritualized. You play the same Sarah McLachlan song over and over." Canadian singer-songwriter Sarah McLachlan is noted for her emotionally wrought lyrics and soft melodies, which makes her popular with young, suburban, college-educated women, many of whom suffer from low self-esteem, poor body image and self-empowerment issues.
- Carnegie Deli: After Carly's transplant, House presents her with fried chicken, which he at first claims is from the Carnegie Deli, but he then admits is from the hospital cafeteria. The Carnegie Deli in Manhattan is arguably the most famous deli in America, known for its enormous sandwiches and cheesecakes, rude waiters and celebrity patrons.
- Six Flags: When Vogler says he found the transplant committee meeting interesting, House says, "Trust me: Six Flags- way more exciting." Six Flags is a chain of amusement parks in North America. The original Six Flags over Texas was named for the number of flags which have flown over the state of Texas in its history. Six Flags Great Adventure in Jackson Township, New Jersey is not far from where this series takes place.
- House realizes Carly Forlano needs a heart transplant based on her psychological profile and the cuts on her leg. He talks to Wilson, but he cannot reveal how he knows this before the test results are in. House says, "I got my aura read today. It said someone close to me had a broken heart." Wilson asks, "Since when do I need the secret pass code to talk to you?" House says he can't tell Wilson what the problem is because of "professional responsibility. Yours. ... I'm not saying you'd want to. I'm saying you'd be obligated to." Wilson realizes this is due to Wilson's position on the transplant committee. Wilson tries to get House to talk, but House cannot, although he wants to do so. Wilson asks, "You sure you're doing the right thing?" House says, "I've come up with a few really great rationalizations." Just then, Cameron and Chase arrive to say their test results have revealed that Carly needs a transplant. Cameron says, "We'll get her on the list immediately," but House says, "She's already on the list."
- House visits Carly for the first time while she is awake, but she recognizes him from an Internet picture. He says he knows about her cutting herself, which indicates she is a bulimic who uses ipecac to induce vomiting, which destroyed her muscles and heart. She confesses to abusing ipecac three times a week. He says he will go before the transplant committee to request a heart and is required to reveal her condition to them, as it lowers her chances of being granted a heart. She says, "So, you're here to tell me I have just a few hours to live." House says, "Unless I lie to the committee. But if they find out, I lose my medical license." He asks how much her life is worth. She accuses him of judging her for her condition, but he shouts, "Oh, stop hiding! I'm asking you if you wanna live or die! You can't even say that!" She asks, "What do you want me to do? Cry?" "Yes!" he says. "I want you tell me that your life is important to you, because I don't know!" He then sighs and says, "Because that's what's on the table right now: Your life." When Carly still does not react, House turns to leave, but she grabs him. Crying, she says she does not want to die.
- Having already manipulated Chase and Foreman with what House dismisses as tactics from a self-help book, Cameron tries to convince House to ease up on Chase. He says to her, "Oh, will you stop it with the book! Why are you doing this?" She says, "People... dismiss me. Because I-I'm a woman, because... I'm... pretty, because... I'm not aggressive. My opinions shouldn't be rejected just because people don't like me!" House reassures her everyone likes her and starts to walk off. She asks him if he likes her. He turns to her for a long beat before saying simply, "No." Cameron is disappointed, but all she says is, "Okay."
- On House's last visit with Mr. Van Der Meer, Van Der Meer tries to use his laptop to communicate, but House says Van Der Meer's muteness was caused by the intubation from his knee surgery. House claims to have cured this with a Botox injection on Van Der Meer's prior visit. Van Der Meer- who has received a large settlement from a malpractice suit- shakes his head to indicate he cannot talk. House tries scaring Van Der Meer, but he does not get a peep. At last, House reveals he knows about the settlement. He asks Van Der Meer to blink twice if he can talk. "Yesterday, I would have said you had to give the money [from the settlement] back. Today, hospital's come into a lot of money," he says, referring to the donation from Vogler. "Mum's the word." Van Der Meer stares for a beat then blinks twice.
- Foreman: How'd she get to you?
House: She's the CEO of Sonyo Cosmetics. Three assistants and 15 VP's checked out who should be treating her. Who da man? I da man. I always suspected.
- Chase: Pretty sure my X-ray machine can take your phone in a fight. It'll fry it.
- Vogler: I wanna run this place like a business.
Cuddy: What, you wanna put more vending machines in the hallway? Maybe a roulette wheel?
Vogler: Heh. Nice one. But I'm serious. The product that you're selling is good health. It shouldn't be a tough sell. If you don't wanna sell, it means you don't care if people get your product. You care if people're healthy, or... you too proud for that?
- Cuddy: I need you to wear your lab coat.
House: I need two days of outrageous sex with someone obscenely younger than you. Like half your age.
- House: I know exactly what he's doing. He's using us to run clinical trials.
Cuddy: Oh, shame on him! Saving lives like that!
- House: This is much more mundane. A billionaire wants to get laid.
Wilson: Billionaires buy movie studios to get laid. They buy hospitals to get respect.
House: And the reason you want respect?
Wilson: [Sighs.] To get laid.
- Vogler: What is a department of Diagnostic Medicine?
Cuddy: That's Dr. House's department. They deal with cases that other doctors can't figure out.
- Carly: Why did you fight for me? You risked so much, and you hardly know me.
House: You're my patient. Don't screw it up!
- Vogler: This is not a game to me, Dr. House.
House: No. It's actually more like we're dancing right now. So let's get to the point: You don't like me. I'm pretty sure I'm not gonna like you. It's nothing personal- I don't like anybody. But none of that really matters, does it? Because you've got money, and I've got tenure. You need full board approval to get rid of me. I've got Cuddy.
House: And Wilson. So, as long as we're stuck with each other, we might as well ignore each other.