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Meaning (House)

Meaning is the first episode of the third season of House and the forty-seventh episode overall.

Plot

The cold opening begins with a family picnic at the home of Richard McNeil and his wife. Richard is a brain cancer surgery patient whose illness has left him paralyzed in a wheelchair. For some reason, he voluntarily drives his wheelchair off the pool edge into the water. Meanwhile, House, still on his ketamine treatment, is seen running and pain-free, as has recovered from multiple gunshot wounds and is back at work, taking on two cases simultaneously: Richard's, and Caren, a young woman paralyzed from the neck down after a yoga session. As House begins to diagnose and treat them, the team notices a distinct change in his attitude toward the patients, and Cameron even catches Richard's wife thanking House for his sensitivity to her husband's situation. House suspects that Richard could possibly walk again, but he has no specific medical proof to back up his hunch and the various treatment avenues he pursues lead nowhere. Cameron and Foreman refuse to indulge House and his theories, which they feel he is pursuing merely to make the case interesting for himself. Cuddy and Wilson also are convinced House is creating a mystery out of Richard's case to cure his own boredom, but he denies it and becomes more frustrated when his theories do not point to a cure for Richard, forcing House to face an unpleasant truth. While running at night, House hypothesizes out of the blue that a corticosteroid production imbalance in Richard's adrenal gland is the cause of the paralysis, which points to Addison's Disease. Although denying House to treat the patient at first, Cuddy does treat Richard with the cortisol injection suggested by House just before he rolls into the elevator. Seconds later Richard strains to rise from his wheel chair and hug his family again after 8 years. Afterwards Wilson and Cuddy discuss telling House his treatment worked, Wilson argues against it reasoning that House being right after all is not the same as having the right to do everything with the patient on House's guess. As Cuddy argues she will be seeing House every day, Wilson closes with "Everybody lies". At the end of the episode, with You Can't Always Get What You Want by The Rolling Stones playing in the background, we see House forging a prescription with Wilson's pad which signals that the pain in his leg is returning.

It is revealed in this episode that the shooter from "No Reason" was never caught.

Richard McNeil: House orders an upper endoscopic ultrasound, Foreman objects that his throat will collapse; it does, and the patient almost dies. Then House orders an MRI scan of the brain, and Foreman tells him that it will cause a bleed into Richard's brain. Again Foreman's predictions hold true, and, once again, the patient almost dies. House comes up with the theory that Richard has Addison's disease. However, Cuddy refuses to follow through with treatment because of the risks (and she also claims she is trying to teach House "A lesson in humility"). At the end of the episode, she follows the family to the elevator and McNeil's disease is relieved by cortisol (although House is not told that his theory worked).

Caren: House decides Caren is faking the paralysis, and proves it by burning her foot, and observing that she moves her leg in reflex. He also decides she is faking the shortness of breath and, to prove it, he threatens to stick a huge needle into her back. Just before he does this, he notices engorged neck veins while she is sitting and instead plunges the needle into her chest. From that, he learns that blood is building up around her heart. House insists on opening her up to find the tumor he then thinks must be there. However, just before the surgery, he notices a discolored toenail. He diagnoses her with scurvy, which he cures with vitamin C, in the form of orange juice.

Behind the scenes

When House and Cuddy are arguing in Cuddy's office about Richard's ongoing treatment she tells him that he comes into her office to say that he can help someone "24 times a year." There are 24 episodes in a typical season of House.
Parts of the episode were filmed at UCLA, with shots of Janss Steps and the Powell Library.
The prescription House forges is for "Vicodin ES 5-500". However, Vicodin ES consists of a ratio of 7.5 mg of hydrocodone to 750 mg of acetaminophen , as opposed to regular-strength Vicodin, which is 5-500.