I have to admit, last week's episode of House had me worried. This whole season has been leaving us viewers very little believability, from the sudden shocks to the less-than-stellar soap opera plots. Tonight's episode proved that the writing team still has it, and by "it" I mean the ability to hit us with some satisfying surprises.

Our patient this week was a guy with some fun neurological symptoms. As is often the case, this patient's condition was often a metaphor for the issues and conflicts facing our regular cast. He begins his medical odyssey in a restaurant where his left arm is doing things only his overridden impulses would do without regulation. Not unlike the outbursts of this season's favorite patient (the guy who couldn't stop himself from saying whatever popped into his head), our split-brained restaurant-goer is living at the mercy of thoughts he usually keeps to himself. Whether it's tossing dinner rolls at an obnoxious restaurant patron or slapping his girlfriend for her irritating concerns, our patient this week is forced to watch his rational and emotional sides compete.

He's not the only one, though. In the wake of last week's double-whammy of House's detox and his consummated romance with Cuddy, things are far from settled. High on life in a way his old self would find annoying, House balances his schedule of treating his patient and trying to deconstruct Cuddy's apprehensive approach to their newfound intimacy. Wilson, as always, tries to help but he's only intermittently effective.

Comedy legend Carl Reiner shows up as a nagging clinic patient who has been uncontrollably squawking recently. Seeing his name in the credits knowing that he wasn't the main patient was a bit of a tip-off that his cameo wasn't actually just a cameo. The way he served as a major point of revelation for the plot was maybe a bit more predictable for it, but I'm glad they used him for something beyond cheap Yiddish-guy laughs.

When treating his split-brained patient, House fixates on pancreatic cancer, sticking with it for much longer than he ever holds to any particular theory. The myriad romance plots run interference so this isn't apparent until the end. On top of the House/Cuddy stuff, there's a romance element to the patient's story and we're still talking about Cameron's dead husband's sperm for some stupid reason. The latter of the three resolves itself in the most flat way possible, but I don't think that plot was meant to work on its own. The second half of this season has been particularly heavy on the old team. I think the production staff on House are trying to get us viewers comfortable with the original characters so they can return next season. After all, the opening credits haven't even changed.

The big twist serves a third-act gut punch of the highest order. In a heated argument, Cuddy fires House. When he tries to reason through the conflict, he discovers that his memories of much of the past few days are compromised at best and utterly false at worst. If last week's one-night detox seemed unbelievably fast and the House/Cuddy romance rather unearned, it's because they were the fantasies of a man losing his mind.

House's hallucinations have taken an even more disturbing turn. Throughout the episode he can be seen playing with what we can assume is Cuddy's lipstick. A troubling montage reveals that it was a pill bottle the whole time. House isn't clean. Quite the opposite, actually. He's been binging the entire episode and indulging some kind of romantic rescue fantasy involving Cuddy. Shaken to his core by this realization, House confesses everything (thankfully off camera) and finally accepts his desperate need for rehab. In a show that has made a point of depicting the hard road as the only true, honest way to achieve anything, this is the only way the season could have ended satisfyingly.

Best Moment: The look on House/Hugh Laurie's face when he realizes what he's become. The sadness and vulnerability are things we've never seen from this character in the show's five year run.

Biggest Laugh/Shock: The laugh- "I slept with Lisa Cuddy" to the entire staff of the hospital. The shock- The full extent of House's psychological breakdown.

Episode Rating: 4.8/5- The Chase/Cameron sperm plot was always stupid and there was no reason to continue with it, but it was otherwise an excellent episode. I find this resolution deeply satisfying and it was great to see House play around with his delusions for a bit. See you next season, House fans.