Hoping for some change on House might be a sign of insanity. House teased me last week by suggesting that House might be able to change his ways with the addition of Methadone. I thought the idea, though flawed, showed lots of potential and it got me really excited about possible changes to the core of the show. It was all passing fancy though as by the end, we were left with pretty much the same old show. This week’s episodes makes no such pretensions. Although its in absolute lockstep with the show’s formula, its still funny, harsh and satisfying.

A patient comes to the crew with an illness that oddly makes him act like a huge jerk. He tells Taub he has a giant nose, he tells every woman around him that he’d like to sleep with them and he’s cruel to his own family. Sometimes funny but often painful, the illness is a complete mystery as usual.

House finds Wilson’s lack of enthusiasm about going to a monster truck rally suspicious and begins snooping. After some sad sad subterfuge involving Taub and a Racquetball, House discovers Wilson’s secret. Wilson has found his long lost mentally ill brother. After Dr House drags the truth out of Wilson, the two share a close friendly moment. House obviously cares about Wilson even with his constant pestering and posing.

The patient who acts like House decides to undergo brain surgery in order to get rid of his sickening attitude. He is willing to risk death rather than drive away the people he loves with his angry sarcastic new attitude. Not surprisingly (mostly because the show still had 15 minutes left) the operation fails and Mr. Grumpypants is left with a big hole in his head and his crappy personality. Right on cue, House has his breakthrough. Some small cyst is the unlikely candidate for the illness and it isn’t long before the patient is back to his home and loving family.

Thankfully, House makes some nearly human moves in this episode. He allows a patient to make a call based strictly on his quality of life rather than the life itself. He also steadfastly stands by Wilson in a moment of need. Despite all the trappings of the character, Laurie continues to shine. He’s been boxed in as an actor to this role in which he can do little but be an ass but when given the opportunity he can expressed with fleeting glances and half intended faces. When given the room, Laurie is simply a good actor.