Last week’s incredible “Bombshells” left the “House” writers with nowhere to go but down. Cuddy’s no longer dying, but House wishes he was, as the realization that his romance is over sinks in. Can House’s return to his bacchanalistic lifestyle ease his pain?

A young and healthy cowboy mounts a bull at a rodeo. He needs to stay seated for 8 seconds to beat the bull and win the challenge. The 8 seconds pass like minutes, as the bull furiously bucks and tries to throw the rider. The cowboy succeeds, and while the rodeo clowns lead the bull away, he faces the cheering crowd triumphantly. But the angry bull breaks away and races back to attack the cowboy, trampling him into the dirt. Hello, Patient of the Week. (Chad Faust, as Lane.)

House’s team has no shortage of past medical information, as the cowboy has a long history of broken bones to show for his career. Unfortunately, metal plates in the cowboy’s head and chest preclude certain diagnostic scans. House himself has withdrawn all of his money from the bank and has holed up in a luxury hotel to drown his sorrows in booze, Vicodin, and hookers.  Just to complicate matters, Foreman and Chase are vying for leadership amongst the team, and newbie Masters is falling in lust with the cowboy.

Wilson’s fears for House mount as House insists he’s ‘fine’. But House’s destructive behavior escalates as he discovers that nothing, not even pretending to shoot an arrow through a hooker, can excite him enough to rouse him from his depression. The team, in turn, tries ever more dramatic procedures on the hapless cowboy, even subjecting him to an MRI so complicated by the metal in his body that they have to inject ice water into his body to counter the incredible heat and internal burning caused by the machine’s rays.

Cuddy, meanwhile, is back at work, and seems impervious to Wilson’s pleas that House desperately needs her. She acknowledges their love, but will not sacrifice her own future to House’s childish, selfish, and destructive lifestyle. Even when Wilson reminds her that she herself said she didn’t want House to change for her, and that the breakup was ill-timed, she holds firm to her belief that “it’s not about what he deserves”.  

House eventually comes to the conclusion that the only way to save the cowboy is to ‘blow up his heart’ in a surgery that essentially will stress the aorta to breaking point in controlled circumstances. As House explains to the cowboy that the surgery may mean he’ll never compete again, the patient, hand tightly wound in the bed sheet, says he can always find something else to love. Masters tattles to Cuddy, who confronts House, saying she won’t authorize the surgery, since she believes he is looking for something to excite him, fill a void, and that his judgment may be impaired. But House stares her down, coldly telling her that his damaged, depressed, drug addled judgment is still better than hers or any other doctor in the hospital, so either have security arrest him, or get out of his way. “And … she caves,” he says, and walks away.

Even the dramatic, gory, and ultimately successful open heart surgery can’t make House feel anything, and he realizes the depth of his depression. While drinking in the hotel bar, he notices a group of college kids whooping it up, carefree and young. Returning to his room, strewn with overturned glasses, empty champagne bottles and the detritus of his debauchery, he swallows another handful of Vicodin, and limps to the balcony. He struggles on to the railing, and stands, hands on the ceiling, for a moment as Wilson arrives at the hotel bar. Seeing a knot of drinkers staring up at the building, Wilson realizes with horror that they are watching House balancing on the railing. House jumps, and as he falls in slow motion, we hear him cry “Cannonball!” His jump lands him in the hotel pool. Underwater, House swims to the surface with a maniacal smile upon his face. Meanwhile the partiers seize the moment to join in the ‘fun’, as many leap into the pool as well. 

Wilson demands to know what House is doing. House, in the middle of the soaked partiers, yells “What do you do when you win?” “Party!” shouts the crowd. “What do you do when you lose?” “Party harder!” they reply. Wilson walks away in saddened disgust while House, bobbing in the water with the drunken crowd, drinks a beer.                

Dramatic and thought provoking, the episode deftly contrasted Masters’ irrational lust for the virile young cowboy with Cuddy and House’s also doomed romance. Sometimes, the love you want is not what is right for either or both of the parties involved. The heart may want what the heart wants, but in a series as intelligent as “House”, the players are too smart to allow the heart to rule the mind.