I will stipulate a few things: Yes, it's a total rip-off of The Mistake, but I'm a sucker for those kind of "multiple viewpoint" episodes, especially ones that play with the characters personas a bit.
I'm pissed that they totally wasted David Anders as Patient Of The Week. They couldn't at least let him use his "Euro-Trash" accent and be a little fun and mysterious before he went bonkers? And the half-naked in the bath scene was a bit sad. No muscle tone whatsoever.
The last problem is that this was the first really good episode since about the third one of the Season, the first one where House has felt completely in character, both as a bastard and as the guy who someone, deep down does care, and to do it they had to get Wilson off the screen completely.
So while I loved the episode, loved Hugh's acting, thought Jesse Spencer was AMAZING, thought all the acting was at a higher level than usual, and had a little happy dance for House/Chase, I'm disgusted to the extent that this made clear how much House/Wilson has been ruined.
Remember, I came to House MD (and LJ) as a House/Wilson shipper. From the first episode I saw, it was "OMG, they are totally fucking, it can't just be me who thinks this." However, once I started reading fic, I also developed a guilty pleasure ship for House/Chase. (Blame the brilliant work of Kohl_Rimmed_Eye, among others.)
The thing that's always been awesome about House/Chase and remained awesome, is that TPTB don't seem to know about it. It's still all looks and hints and subtext. There's no blatant fan-service and there for no blatant slaps in the face to make you believe it's not happening. Although there was that punch in the face. (My fanon was that Wilson was jealous of House getting that physical with anybody else and that's what led to him going to Tritter right after he saw Chase.)
I still think House and Wilson might be fucking, but that their emotional connection has been shattered, whereas House and Chase might have had sex in the past, but there's still some unresolved feelings of an emotional nature. Compare the way House looked at Chase in their last scene to the way he's looked at Wilson lately. I'm still not sure how much is just Paranoid Bitching Of A Paranoid Bitch on my end, believing that Hugh & RSL have been giving non-shippy marching orders and how much is either fatigue on the actor's parts, bad writing, or the fact that it's been a long time since Hugh was all alone in West Hollywood.
All I can say is Hugh & Jesse were spectacular together, and the subtext was all there. It's sad that the House/Wilson of The Mistake is long gone, but if we can get this kind of acting and some intelligent dialogue and maybe a piano-gasm, I might be able to stay with the show a while longer.
As for the actual plot...I did like how it was a de-construction of House's method and what he does to the people who work for him and even how much he has to brutalize them to get the results he wants. I think it was almost honest about a lot of things...at least until the end.
And yes, the ending was a complete and total cop-out, but it was inevitable. (I even liked how House basically shouted exactly what the audience should have been thinking.) People Don't Change. This show worships the Status Quo. Which is funny, because they keep driving House deeper and darker, but it never has any real consequences. Psych Ward, Jail, Tracking Anklet, Cuddy etc. And in the end, he's still essentially at the same place he was in the Pilot. Which is ok with me. I was rooting for relapse during the whole ludicrous "clean, but drinking" period
and I've always said, I don't want him to get "better" or "well" or "happy."
I just want the writers to stop pretending he will.