- Ramon: "Taking painkillers breaks my deal?!"
- House: "The point is to suffer like your savior did right? Well he didn’t take myrrh, the Tylenol of ancient Rome. And his nails went through his wrists, not through his palms - palms are for sissies. What about the thirty-nine lashes and the beatings and the crown of thorns? What you go through is closer to a bad manicure than a crucifixion."
- Ramon: "It’s not about showing him my pain, its about showing him my faith. If he asks me to die for my daughter, I‘ll do it gladly."
- — Small Sacrifices
Small Sacrifices is a 7th season episode of House which first aired on November 22, 2010.
A patient is admitted to Princeton Plainsboro after re-enacting the Crucifixion. The team finds the diagnosis, but the treatment will test the patient‘s faith. House, Cuddy, Sam, Wilson, and the team attend the Chairman of the Board‘s wedding, and Wilson's relationship with Sam unexpectedly changes, while Taub questions his wife's friendship with a member of her infidelity support group. After getting caught up in another lie, House can’t convince Cuddy that “work lies” should be treated differently from “relationship lies” and instead has to try to convince Cuddy that she will lie to serve her own purposes when it suits her.
A man is re-enacting the crucifixion by carrying a heavy wooden cross up a hill. His companions tie his arms and legs to the cross, then pound spikes through the palms of his hand. The man playing Christ just keeps praying to himself. The cross is lifted to the vertical as the man bleeds from his hands. However, all of a sudden, he starts vomiting a black liquid out of his mouth. His companions know something is wrong and immediately work to get him down.
Cuddy intercepts House in the lobby. They are still fighting about his earlier lie as she presents the case of the man to him. House gets interested when he hears about the crucifixion. Cuddy still won’t talk to him about his lie, but he threatens not to attend the Chairman of the Board’s wedding that weekend. He agrees to go on the condition that she not treat it as an admission that his lie to her was the wrong thing to do. Cuddy also reminds him about the rehearsal dinner they have agreed to attend.
House goes to see the patient, who tells him that when his daughter had phase 4 cancer, he pledged to God to nail himself to a cross every year that his daughter lived, and since then she has been cancer free for four years. He admits his daughter’s mother left him over it. The daughter asks that if God wasn’t responsible, how can he explain why she’s better now. House thinks that there must be a logical explanation for what happened, but the patient merely jumped for the easy answer. Chase sends House out of the room so he can do a lumbar puncture.
Wilson finds House in his office, asking how the 8 year old daughter could have stopped having cancer in three weeks. House focuses on Wilson’s lateness and thinks he’s lying about why. Wilson finally admits he’s late because he bought Sam an engagement ring - he’s planning to propose at the Chairman’s wedding. Wilson realizes that House still hasn’t apologized to Cuddy and tells him to say he’s sorry, even if he doesn‘t mean it. Instead, House comes up with a strategy.
The team is talking about the age difference between the Chairman and his bride, and Martha M. Masters chirps up to say her father is 19 years older than her mother and they’ve been married for over 30 years. When Foreman says it’s different because the Chairman is powerful and the bride is beautiful, Masters counters that her father was Classics chair at Columbia University and his wife was his “gorgeous“ student. Taub mentions something and everyone realizes his wife may be cheating on him. All the infection tests are negative, but Taub realizes that the patient works around animals and may have been contaminated with horse bacteria because of his open wounds. They go to give the patient the news, but he tells them his teeth are starting to fall out, ruling out Taub’s diagnosis.
House starts a new differential, and Taub suggests radiation sickness, but there isn’t a radiation source. Masters suggests Karposi’s sarcoma (this shouldn't be in the differential, doesn't make sense), but there are no skin lesions. Chase suggests heavy metal poisoning and House orders tests and an environmental scan. When Taub tries to get out of doing the tests, House realizes he’s trying to catch his wife cheating, but allows him to go anyway.
House puts on a tie and asks Cuddy to help him get the daughter’s medical records, but she says if the father opposes the request, there‘s nothing she can do. She thinks he looks weird in a tie. She then realizes that House was fishing for her to lie about actually liking the way he looked.
Chase and Masters go to the patient’s apartment. Masters says she asked permission. Chase doesn’t believe her until, while he’s trying to pick the lock, she tells him that the patient never locks his door and goes opens it. The apartment is very bare. They go looking for heavy metals and talk about his crucifixion. They finally realize the patient is thin because he’s not eating properly, and the tooth loss is due to malnutrition. The theory about the horse bacteria is back on the board.
House goes to Wilson’s office to find the door locked. House has scammed the daughter’s medical records by forging Cuddy’s signature and wants Wilson to look at the file. Wilson reminds House that he’s just added another lie. Wilson says he’s too busy, but House finds out that Wilson is reviewing Sam’s clinical files to make sure they’re in order for her new boss the following Monday. If he doesn’t help her, she can’t go to the wedding and he can’t propose. House tries to talk him out of it, but realizes he really wants him to look at the daughter’s file instead.
Taub arrives at his house and finds Rachel just coming back. She thinks he has been checking up on her and he admits he has. She says she made a new friend in her online infidelity support group and didn’t want him to know about it.
Masters confronts the patient about starving himself, and he improves on better food, but he complains about pain in his legs - a 9.5 out of 10. Masters asks him why he’s smiling, but he says he’s not.
House tests the patient and realizes his emotions are all screwed up. House asks for a differential on a 33 year old carpenter with narcissism, delusions of grandeur, and hallucinations. Chase realizes he’s talking about Jesus. Masters suggests schizophrenia, and the team realizes the patient may have a neurological disorder. House orders an MRI of his brain.
Cuddy has found out about the daughter’s file and thinks that the patient changed his mind, but House admits he forged her signature. He tries to catch her in a lie about her age, but she says she really is 43 - she lied to HR when she first applied for the job by saying she was 31, not 29. House says he will prove that she has embraced lying.
Taub tells the team Rachel is just in an online support group, but Chase still thinks she’s cheating. They see multiple dense lesions indicative of multiple sclerosis. The malnutrition hid it by suppressing the immune system. Now, the better diet will just make the symptoms worse.
House tells him his experiences are due to lesions in his temporal lobe. The patient says he still has faith and the treatment for the MS hasn’t affected that. The patient then starts coughing. House pours him some water, but when the patient goes to reach for it, he realizes he can’t move his arm. House realizes his arm is paralyzed.
Despite the fact the symptoms, including the paralysis, indicate MS, the patient is not improving on prednisone. House realizes he has a rare form - Marburg MS. The patient will be dead in less than three days unless they use a treatment based on stem cells. However, given the patient’s religious beliefs, it is unlikely he would agree to it. House suggests lying, but realizes Masters will tell the patient. He tells the team to confirm then ask the patient if he will consent to the treatment.
Wilson finds a well dressed House in his office. Wilson reviewed the daughter’s file - she did have stage 4 cancer that usually doesn’t respond to chemotherapy. They gave it to her anyway and it worked. Wilson admits that sometimes cancer disappears for no good reason, and he’s fine with that. Wilson goes back to review Sam’s files, but House has been reviewing them too and is worried that Sam has been fudging her charts on five cases where the radiation damage doesn’t match the dose. Wilson puts it down to variability, but House doesn’t think that explains it. Wilson admits he has come to the same conclusion as House. Wilson has confronted Sam already and she denied doing anything wrong. House realizes that, because all five patients were terminal, Sam gave them a bigger dose hoping it might work. He tells Wilson Sam is perfect for him.
House is talking to Cuddy about how much he hates rehearsal dinners. He doesn’t think the marriage will last, and Cuddy doesn’t either. As they go to leave, House gets a call that his patient is refusing treatment. He admits it’s just an excuse so that he won’t have to go to the rehearsal.
The patient is refusing treatment for religious reasons. House points out the patient loaded up on ibuprofen for the pain and the nails went through his palms, not his wrists. House says that the patient is afraid of losing his faith if he’s cured.
House compares the patient’s absolute principles to Masters’. When she argues it’s not the same, House says the problem is trying to apply the same rigid set of principles to every situation. Masters suggests telling the daughter about her father’s choice, and House agrees.
The daughter tries to talk her father into accepting treatment, but he’s resolute and tells her that she will understand one day. She says if God wants him to refuse treatment, she hates God.
The party is on at the wedding. Chase is trying to get Foreman to chase girls, but he’s not interested. Taub and Rachel are arguing about her new friend and how she’s more open with the friend than him. He accuses her of emotional infidelity and she walks away. House and Cuddy are dancing. She says she needs an apology, not flattery. Foreman finally takes an interest in the women Chase has met.
Masters is back at the hospital and apologizes for what happened with the daughter. The patient admits he’s afraid of dying, even though he believes he’s going to heaven. However, he believes that belief defines a person.
Taub goes to apologize to Rachel. She tells him her friend helps her feel better about him. He asks her to stop talking to him, but she refuses because she says she needs the new friend right now.
House asks Cuddy what her wedding would be like. She says she would wear white because it would be her first time. House tells her he knows that she was married for six days in 1987 - she knew too much about New Jersey divorce law when discussing her prediction about the length of the Chairman’s wedding. House then forgives her for lying. Cuddy tells him he played it well, but doesn’t forgive him.
Wilson is talking to Sam about the newly married couple, gets down on one knee, pulls out the ring and proposes. When she asks what brought it on, he tells her that he agrees with her about the radiation she gave the patients. However, she doesn’t think that Wilson believes her about not giving the patients the wrong dose. She walks off angry.
Foreman sees Chase leaving with both women and drinks both drinks he brought for them.
House, Taub, Foreman and Wilson are discussing Chase’s scoring with at least three women. Taub admits he has realized that although his wife forgave him, the feelings she had about his cheating never went away. Suddenly, House realizes something. He goes back to the hospital to run one more test.
House goes to see the patient to tell him death is near, then tells him he has run a PET scan on his daughter. He tells him that the daughter still has cancer. She was given CT scans, which don’t pick up microtumors. The patient is skeptical, but House tells him he ran the test twice. The patient agrees to treatment.
Chase apologizes to Foreman for leaving him out, but says he had no choice because the girls wanted a threesome. Taub says they’re overrated and Chase and Foreman call him on his bluff. They see something on the patient’s MRI and call House.
House brings the daughter’s clean PET scan to the patient and admits he lied to him. However, the patient is getting better. His emotional affect has returned. The patient explains it by God being merciful. House says he’s trying to have it both ways. The patient asks to see his daughter.
Masters is upset that House didn’t tell her about the deception. Masters says she can’t continue to work like this, but House says he can.
Wilson returns home to find Sam packing. When Sam shows no intention of working things out, Wilson accuses her of quitting on him once again. She leaves without saying anything else.
Cuddy congratulates House on his case. He talks to her about his credo everybody lies and how the corollary of that is that trust is meaningless. However, he realized that perhaps he might be wrong and apologizes for lying to her and says he won’t do it again.
House is at home when Wilson comes by to tell him about Sam. He tells Wilson that Cuddy is coming over and admits he apologized to her. Wilson tells him he did the right thing, but House says he lied about the apology. Wilson still thinks he did the right thing.
Zebra Factor 7/10
Like other diseases that are considered to be borderline within the family of diseases that present with multiple sclerosis symptoms, Marburg MS is very rare.
The episode focuses mainly on the small sacrifices of two different kinds, though both sacrifices revolve around House:
- House lies to the patient to shatter his faith but make him better.
- House lies to Cuddy when he tells her he's sorry.
Trivia and Cultural References
- The plot of this episode is similar to the story of Rolando Ocampo, who has been crucifying himself since 1990 as a sign of gratitude to God. Ocampo believed that God saved his daughter from dying after birth. Ocampo crucifies himself every year on Good Friday.
- Crucifixion was an ancient method of execution where a person was tied or nailed to a post or cross. It was used in many Mediterranean empires for about 1000 years, but it stopped in Rome when Constantine outlawed the practice because of his newfound Christian faith.
- “Choking the chicken” is one of many euphemisms for male masturbation.
- House makes a go at the patient's faith when he is asked, "You don't believe in God?" and House responds not since he had grown his "curly hairs", referring of course to his pubic hairs.
- House defers to his motto, "Everybody lies," again.
- House implies he will repay Cuddy sexually and asks her to thank "tat for tit."
- House makes another reference to Cuddy “lying about being a woman”, another reference to her transsexual character on Ally McBeal
- Mister Rogers is a reference to the title character on the long running PBS children's program.
- When House references Miss Moneypenny while wearing his tuxedo, he is acknowledging the iconic association between the tuxedo and James Bond. Bond wears what he would refer to as a “dinner jacket“ in every Bond film. Wilson's reply is an homage to the classic Bond villain's foreign accent and hackneyed dialogue.
- Myrrh is the resin from a type of thorny tree. It is still highly prized and has been used since ancient times in perfume, medicine and incense. It is still recommended for use in treating tooth pain.
- Inherit the Wind was a 1950’s play dramatizing the Scope’s Monkey Trial in 1925. It was later made into a movie and a television movie.
- The sub-plot about Sanford Wells' wedding to a much younger woman and Masters' insistence that there is nothing wrong with such a relationship is a multiple dig at Amber Tamblyn. At the time, Tamblyn was dating her current husband David Cross, who is also nineteen years older than Tamblyn (the same age difference between Masters' parents). In addition, Tamblyn's father Russ Tamblyn was 49 when Tamblyn was born to Russ's third wife Bonnie, who is thirteen years younger than he is. The marriage to Bonnie has lasted almost thirty years (the same as Masters' parents) and persists to the present.
- House's line "If you prick me, do I not bleed?" when confronted by Cuddy is a reference to Shylock's famous monologue in Shakespeare's The Merchant of Venice.
- House begins to uncover Cuddy's past lies.
- Its discovered that Cuddy lied to Human Resources about her age.
- Cuddy's true age is revealed to be forty-three.
- It's also revealed that Cuddy was married for six days in 1987.
- Wilson proposes marriage to Sam, but there is a misunderstanding over her hospital charts. Because of this, Sam breaks up with Wilson.
- House finally apologizes to Cuddy.
- House tells Wilson that he faked his apology.
- Hugh Laurie as Dr. Gregory House
- Lisa Edelstein as Dr. Lisa Cuddy
- Omar Epps as Dr. Eric Foreman
- Robert Sean Leonard as Dr. James Wilson
- Peter Jacobson as Dr. Chris Taub
- Jesse Spencer as Dr. Robert Chase
- Olivia Wilde as Dr. Remy 'Thirteen' Hadley (credit only)
- Amber Tamblyn as Martha M. Masters
- Cynthia Watros as Sam Carr
- Jennifer Crystal Foley as Rachel Taub
- Kayla Ewell as Nika
- Stella Maeve as Kenzie
- Nigel Gibbs as Sanford Wells
- Madalyn Horcher as Marisa Silva
- Kuno Becker as Ramon Silva
- Jaime Zevallos as Marcus
- Alan Marco as Victor
- Kirby Griffin as Casey Wells
- Ed Williams as Anthony
- Bobbin Bergstrom as Nurse (recurring role)
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