**Flashes back to S3 blooper reel with the weird I think clay thing stuck to the pestle** I believe that was a catnip mouse toy.

I love that episode. I seem to have lost the DVD that it's on, so it's been a while since I saw it. I loved how they all started out looking so snazzy and got more and more frayed as the night went on. I was thinking when Chase walked into the patient's room early in the evening that it looked like a GQ model had arrived. I also loved the moment when he asked about the old lady's "sed rate" or something to try to to figure out how to treat the kid -- it was a very House-like train of thought and, of course, there was Wilson to shoot it down. LOL That's entertainment! Everything about this episode was entertaining--from literary references to Wilson at the poker table keeping Cuddy distracted.

extra_cat, you lost a House DVD? I feel faint. I send you good-luck vibes to help you find it. I love All In. I just wish I understood more about poker and betting so that the poker stuff would have made more sense to me. I understood the basics (the pocket aces, for example), but I wish I knew all the ins and outs.

The thing that struck me again during this episode was Wilson's fundamental blindness in assuming that what House does in diagnosing his patients is so much more than simply guesswork. Wilson's statement that the correct diagnosis was due to guesswork and House's reply that what he does is more than that really pointed out a fundamental lack of knowledge on Wilson's part, one that extended all the way into S3's Tritter arc and that probably contributed to the trainwreck that went on then. House's acceptance, after the one line when he attempted to correct this error in Wilson's level of knowledge, seems to be something that he has come to live with. It seemed as if that sort of reaction from the people around him was something he had seen before from others and that Wilson was just one more of those who made judgments about him based on their own false assumptions. It served to strengthen his own sense of isolation from others, even Wilson.

Wilson's statement that the correct diagnosis was due to guesswork and House's reply that what he does is more than that really pointed out a fundamental lack of knowledge on Wilson's part, one that extended all the way into S3's Tritter arc and that probably contributed to the trainwreck that went on then. Without removing House's own culpability, I've always believed that to be true. I thought it was the wrong decision to drop Wilson's own actions as a contributing factor to the Tritter mess--I think there would have been much less of a need to make such a demarcation between the Tritter arc and the second half of the season if we'd seen a throughline of the issues raised in Meaning, which as you say, had been raised before in season two.

I do agree with you about Wilson's actions contributing in a large way to the Tritter mess and also agree with you about Wilson not ever being called to account for those actions. What I was kind of getting from this episode is that House has probably felt isolated for a very long time, perhaps most of his life, because of the way his mind works. He is able to put all kinds of things together to arrive at the diagnosis of a patient. I think that he's had the ability to draw conclusions in the same way for a very long time, certainly it existed before he became a doctor. The isolation seems to stem in part from the inability of those around him to see that he's not just guessing when he arrives at the conclusion of a thought process. Those around him ascribe it to lucky guesses when in fact it is not. Wilson in the scene was saying what everyone around House has probably said at one time or another, not seeing that there is much more than guessing going on. It's the end of a process that they aren't able to see and thus try to put it on a level they can comprehend. I think House is isolated by that ability and by the fact that those around him are unable to understand that process.

ITA misanthropicobs that House doesn't think so much better as differently. He is able to not make the assumptions that everyone else makes so he can see the problems without blinders. Seems to me he can think linearly but also in a pattern-recognition sort of way that allows him to interpret disparate data much more accurately: he takes in data until the pattern registers and that's why he's always compelled by the answer that "fits." It actually does fit, like getting the key to a cryptogram where seemingly random data can be shoved over a notch or two to spell out a genuine message. And since no one else sees the pattern evolving into focus (why House can predict outcomes) they discount his abilities. To House it must be like seeing the world in color when everyone else sees black and white and they neither believe him nor understand the implications of what he tells them. So, yes, seems that his greatest strength, his thinking, is also his greatest impediment to happiness, because he is so fundamentally misunderstood and undervalued (at least when his brilliance is said to be lucky guesses ad nauseum). House is amazingly patient and accepting of how he is seen and I suspect that may be why he has developed all the game-playing as both coping methods and teaching tools and of course to have fun with people that don't see what he does. And, yes I know he's a fictional character, but dang it, such a compelling one to analyze!

Yes Boffle, you've said it much better than I can. Your description of taking in data till it "fits" sounds very right for House. He does think differently from the people around him and this difference isolates him from other people. It's probably something he's been aware of for a large part of his life. I think that House's line in this episode saying that what he does is more than guesswork in response to Wilson's comment about him guessing is probably as close as he can come to describing his thought process. Also, since he can't explain it so others can understand how he does what he does, he just lets people think what they want and that uncomprehension by others contributes to his isolation. It wasn't till S3 that Wilson finally came to a partial realization that it's not all guesswork.

Part of the misperception, of course, is because along the way to the diagnosis House does make a lot of educated guesses. Test for X. That's not it? Do a lumbar puncture to test for Y. Nope. Do such-and-such to check for Z. And what others don't necessarily see is that, while he is testing for the most likely causes, he is also gathering information. And there comes a time when he has all the information and all it takes is one word or thought to make him rearrange all the information in his mind and get the answer. Others think that was just the next guess in the series and don't see that, at that point, it isn't a guess any more.

Part of the misperception, of course, is because along the way to the diagnosis House does make a lot of educated guesses. Test for X. That's not it? Do a lumbar puncture to test for Y. Nope. Do such-and-such to check for Z. The thing is, though, this educated guessing on the way to diagnosis is the one thing The American Medical Association and other medical professionals agree on as accurate about House :D . It's not like other doctors go straight to the right diagnosis even when they do get one right themselves, unless it's very straightforward. Rule out tests are common. So that part of House's method should be familiar. What House has that other physicians don't (although Chase seems to have a touch) is more of a sense of an emerging pattern--so he's guessing less, not more, though his pattern is usually not obvious to others. That's what Wilson misses--House using his intuitive sense to find a pattern rather than straight logic. And I should say that Wilson doesn't always doubt this aspect--he covered House in the Great Tick Search. But All In did show he has--or had--trouble with it nonetheless.

I agree. But I think it's hard for Wilson to see that when the pattern finally falls into place for House it wasn't just the next educated guess. In this episode Wilson thinks House was lucky because, if it wasn't Erdheim-Chester House didn't have any tissue samples to test for the other possibilities. But House had realized that he had been right all along. It was Erdheim-Chester but his experience with Esther allowed him to make the diagnosis very early -- too early. The purple papules hadn't had a chance to form when they did the colonoscopy. So, while House knew that this wasn't the next educated guess, Wilson saw it as lucky that his last chance to make a diagnosis had been the correct guess.

That way of thinking is what isolates House from those around him. He knows that what he does is not a series of lucky guesses, as has been expressed by the other characters on more than one occasion, but because the process is so integral to who he is it is something that he can't explain. It's just him and the way he sees the world, not some conscious method that he has adopted. That's his way of looking at everything and Wilson, Cuddy and the others can't see it because they don't think that way. That different way of thinking is the main thing that sets him apart from everyone around him. It isn't until S3 that Cuddy and Wilson come to at least a partial understanding of the difference between what House does in diagnosing cases and what others do.

which is why that scene in MLC is so pivotal to the series, to Wilson's understanding of his friend. I think that Cuddy knows that House has this extraordinary gift. I don't think she can explain it, and she doesn't understand it, but she knows its there and she knows its not a "lucky guess." It's why she values him so highly as a physician and willing to take such a chance on him. But even she loses sight of the fact that House has this gifted insight.

I think as science gets more of a peek into how we learn and process information, the gap between science and folk wisdom is lessening, not widening. There's now evidence that our intuitive sense is very real and very ancient--it's a non-verbal way of instantly processing information to spot patterns in order to react quickly, whether to pounce or to run depends on the situation :D . I think House's intuitive sense is as highly developed as his rational logical side, and it's both sides working together that is so unusual and so effective. Because intuition--the sifting of information to spot underlying patterns--is non-verbal and extremely fast, it doesn't lend itself to explanation--as folk wisdom has always had it! It's a way of working that particularly sticks out in a scientific setting, and yet it's always been there. There are many stories of dreams and daydreams leading to discoveries. House knows enough to pay attention to that niggling sense of something being important or missing and to allow his subconscious to work. It's a hard thing to teach, and he explains more often about logic and facts and numbers.