A young boy suffers from respiratory trouble after dreaming about a spirit who walks into his room and strangles him. House believes it is Sudden Unexpected Nocturnal Death Syndrome which kills males who are of Hmong heritage. It is soon noted that medicine is failing him as none of the treatments work. The grandfather believes that, similarly to his son who murdered his boss with a sledgehammer, his grandson is possessed. When science appears to provide no answer and thus no cure, the boy's mother gives up her reluctance to believe in alternative spiritual treatments. House is extremely distressed that religion could provide a cure science (he) was unable to give. The boy dreams that his grandfather is the one strangling him and when he awakes we see he has red imprints around his neck. We see the effects but not the cause.
The theme of dreams runs throughout the episode and provides scenarios in which Park fantasises about Chase and he fantasises about her, both claiming that dreams don't mean anything. Taub convinces Park that it means trust, security and friendship and so she tries to prove her theory by farting in the elevator. I love Chase's reactions to the things she says. Again we see the effects (sex dreams) but not necessarily the true cause (reason behind) the dream. It leads us perhaps to understand that not everything can be explained and that the 'obvious' explanation doesn't necessarily prove to be the correct one.
We see a further development in House's relationship with Dominika as he feels the bond between them is perhaps stronger than he had previously believed. She likes guns, she reads physics books about one of his favourite subjects, dark matter, and shows true interest and understanding. Notably, Dominika compares the understanding of dark matter, of which we can see only the effect and not the cause to spiritualism and occultism. In a true Housian way, as soon as happiness begins to materialise the ceiling drops. They are about to have sex when Dominika takes a call telling her that her citizenship was approved and that they had sent notifications by post several times. Whether Dominika leaves through feeling betrayed and angry or whether she leaves because that is what she would have done anyway, we never know. House is obviously affected by this and the expression on his face shows that he truly doesn't want her to leave. Once again House sabotages (unconsciously most likely) his relationship with the woman he cares about. He knew that she would find out eventually and that what he had done would upset her. He pushed her away because he's so terrified of happiness. That's not to say he doesn't want to be happy, and he doesn't want to be with her, he just doesn't expect it to last. Cue: Cuddy. The green card thus seems to represent the Vicodin he took when Cuddy was thought to have cancer. It's self preservation, a coping mechanism which is extraordinarily ironic. He precipitates pain only to feel the brute force of its impact.
Following the 'multiple possibilities' theme of the episode, we can't say whether it was the Ibuprofen or the grandfather's exorcism which heals Luke's heart. Adams says it's hard to believe that aspirin could heal him, the mother then says that it's hard for Adams to believe that the spiritual intervention worked. As Taub says 'there were two things we thought were impossible, one of them wasn't, that's all we know.' One of things that I have always loved about House is that when it comes to debates of this genre they never tell us what to think, they present the facts and let us decide. We fill in the blanks in our own ways, according to what makes sense for us.
So we see the beginning of the end. "I have cancer House". Wilson's expression and then House's disbelief. All this time I've been focusing on House being the one who could be ill, who fears that he will become incapable of practising medicine, losing his mind. When in fact he could lose a large part of his heart. Wilson. House has lost a lot of people throughout the years, but I honestly think Wilson's death could kill him. I'm a fan of dark and dramatic as I think its an essential part of Housian nature but it really does hit you hard when you imagine a possible scenario where Wilson is gone and House is alone. It was an incredible scene. I know this arc will be spectacular, one step closer to the end.