The series begins with elementary school teacher Rebecca Adler suffering a seizure during class. None of the doctors who try tackling her case are able to diagnose the underlying problem, and her case is eventually referred by her "cousin", oncologist Dr. James Wilson to his colleague Dr. Gregory House, the head of diagnostic medicine at Princeton Plainsboro Hospital.
House's team of Drs. Allison Cameron, Eric Foreman, and Robert Chase begin trying to diagnose Rebecca, but an attempt at giving her an MRI goes horribly wrong when she proves allergic to the contrast material, while another attempted test gets called off when the Dean of Medicine (and therefore House's boss), Dr. Lisa Cuddy, revokes all testing and surgical privileges for the team in order to force him to do his clinic hours — starting with a man with bright orange skin.
After several more tests and treatments fail to yield any useful result, House sends Chase and Foreman to break into Rebecca's apartment, which leads to two breakthroughs — firstly Rebecca isn't actually related to Wilson at all, and secondly, there's a very real chance that she has a tapeworm in her brain from eating improperly prepared pork.
Unfortunately, Rebecca is refusing any further treatments, having lost faith in House and his team, and now determined to die with dignity. House angrily lectures her on the futility of this decision, and manages to somewhat bring her around by telling her the truth about the incident which crippled him, when he suffered an infarction in his leg muscle, which had to be removed, leaving him with severely compromised mobility and in chronic pain. However, Rebecca still refuses any invasive procedures, leaving them with the problem of proving the tapeworm's existence.
Chase eventually manages to solve the problem by realizing that if she has one tapeworm, she likely has others. The solution to proving this ends up being x-raying her leg, where sure enough, another tapeworm is embedded. Upon this revelation, she finally consents to taking the medication to rid herself of the worms once and for all.
In the closing scene, House and Wilson debate their respective approaches to medicine, and the all-important question of how much a doctor should care about and involve themselves with their patients.
Tropes include:
- Armor-Piercing Question: After Foreman and Cameron are left aghast by House's suggestion to stop treatment on Rebecca in order to see how fast she deteriorates in order to narrow down the likely cause of her illness, House asks the two if they have any better suggestions. They don't.
- Artistic License – Medicine: After getting radiation and steroid treatments, Rebecca would be heavily immunocompromised for a good few weeks, meaning that no matter how much they wanted to do so, Cameron and Chase should have recognized that bringing sixteen children into her room to cheer her up would have been an incredibly bad idea.
- Black Blood: Appears several times, likely as a side-effect of the episode's stylized cinematography. Later episodes would show copious amounts of red blood, so it doesn't appear to have been an issue with the censors.
- Boring, but Practical: The solution to proving that Rebecca has a tapeworm in her brain — and thereby convincing her to accept further treatment — ends up being x-raying her. Not in her head, mind you, as it wouldn't show up clearly enough, but in her leg. In turn, the solution to getting rid of the worms is just a couple of worming pills.
- Brick Joke: Halfway through the episode, House dupes a clinic patient into accepting candies as medication for his imaginary illness. At the end, the patient comes back, looking for a refill.
- Captain Oblivious: Lampshaded by House to the show's first-ever clinic patient — who comes in complaining of a sore back, despite the far more obvious issue with his skin pigmentation — with this immortal line:House: You're orange, you moron!
- Characterization Marches On:
- This episode's version of Cuddy barely resembles the character she'd become. She's far colder and more impersonal during her interactions with House, clearly doesn't like him on a personal level, and genuinely seems to want rid of him — she implies several times that the only reason she hasn't done so is because he has tenure, and happens to be really good at his job — instead of only threatening to fire him either as a joke or because he's done something to seriously annoy her. At one point she even revokes all surgical and testing privileges from House and his team just because he isn't doing sufficient clinic hours, which is the kind of dick move you'd expect from one of the later Arc Villains like Vogler.
- It's subtle, but this episode's version of Foreman comes across as far more of a Naïve Newcomer than in later episodes, where he's usually the most confident and level-headed of House's team.
- Cameron spends most of the episode acting as House's effective second-in-command, a position that Foreman would more commonly hold later on. It's also hinted that House hired her because he's attracted to her (though he denies this), which later in the first season gets flipped around to Cameron having a one-sided crush on him.
- Chase seems much more lazy and irresponsible than usual. He did occasionally behave in such a manner later in the series, but usually only when he was being distracted by personal issues.
- Conflict Ball: House makes the correct diagnosis with nearly ten minutes of the episode remaining, but Rebecca suddenly decides to refuse any further treatment, dragging out the remainder of the storyline while House manages to talk her over (while also giving his backstory in the process).
- Early-Installment Weirdness:
- The episode has highly stylized cinematography, with an extreme Orange/Blue Contrast filter. Future episodes of the show had more conventional cinematography.
- The incidental music score is much more energetic and omnipresent than the sparser scores featured in future episodes. This episode's theme tune is an instrumental cover of "Pure Imagination" from Willy Wonka & the Chocolate Factory, which would later be replaced by Massive Attack's "Teardrop" in North American airings, and an original composition elsewhere.
- The opening sequence is absent, with the episode just having a simple title card, and the cast credits being shown over the opening scenes.
- Instant Drama, Just Add Tracheotomy: Pops up early in the episode, with Rebecca having an allergic reaction to the MRI contrast material, forcing House's team to perform a tracheotomy to prevent her from choking.
- Hope Spot: At one point, House seemingly succeeds in curing Rebecca via use of steroids. The fact that there's still half of the episode to go at this point should be a clue that it's not going to be that simple.
- Hypochondria: One of House's clinic patients is the first of many people in the series to suffer from this. House dupes him into taking some candies as for his "illness" — and at the end of the episode, he shows up looking for a refill.
- I Did What I Had to Do: Foreman tries pulling this argument with regards to the robbery he committed when he was a teenager, claiming that he grew up in a poor, crime-ridden neighborhood. Cameron calls him out on this.
- Info Dump: House delivers one of these to Rebecca, about the circumstances that landed him with his limp — though as we find out much later in the season in "Three Stories", he left out quite a lot of details, most notably the fact that Cuddy was the attending surgeon.
- Jerkass Has a Point: The episode serves as one long establishment of House's habit of doing this, mostly with his attitude towards treating Rebecca, but also with the clinic patient, whose wife he correctly surmises is cheating on him.
- Orange/Blue Contrast: Taken to extremes, with all colors in the episode other than orange and certain shades of blue-green being completely desaturated. Which has the side-effect of the "Orange Patient" looking mostly the same as everyone else, just with what appears to be a heavy suntan. The only exception to this is in the exterior shots of Princeton Plainsboro, which were filmed for later episodes and edited into this one, and thus use the more conventional visual style of the actual series.
- Profound by Pop Song: When House's boss Cuddy complains about House's apathy towards his job he responds with this:House: As the philosopher Jagger said, "You can't always get what you want."
- Shout-Out: Rebecca's surname, Adler, is the first of many references to Sherlock Holmes in the series; in this case, it's a reference to the character of Irene Adler from "A Scandal in Bohemia". Rebecca gaining House's respect within a single meeting also seems to refer to the literary Adler.
- The first name that Wilson mistakes Rebecca for having, Rachel, is likely a reference to the "RACHE" carving from "A Study in Scarlet".
- Spotting the Thread:
- Foreman works out that Rebecca isn't actually related to Wilson at all, since Wilson is Jewish, but Rebecca isn't, as indicated by the latter keeping ham in her fridge. Wilson tries to Hand Wave it as Rebecca being a non-observant Jew... but screws it up by calling her "Rachel", further undermining his story.
- This in turn causes House to work out that since Rebecca does eat non-kosher food, it means she likely picked up a tapeworm from some improperly-prepared pork, and that her briefly improving earlier in the episode was the result of the steroids nearly killing the worm, but failing to finish it off.
- Throw the Dog a Bone: Cuddy makes sure that House's first clinic patient is an interesting one; a man complaining of back pain who's turned orange.
