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Both Sides Now

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Both Sides Now
Both Sides Now
May 11, 2009
Episode Number
5.24 Rating
Final Diagnosis
Zebra Factor
Amber Hallucination: "So, this is the story you made up about who you are. It’s a nice one."
Kutner Hallucination: "Too bad it isn’t true."
―Both Sides Now

Both Sides Now is the 5th season finale of House which first aired on May 11, 2009. After his detox session and passionate encounter with Cuddy, House starts to wonder why she doesn’t seem to want to have anything to do with him anymore. However, his team starts to notice that House is acting even more strangely than normal, and House seems intent on using an older clinic patient to try to keep Cuddy’s attention focused on him. When House pushes the matter with Cuddy to the limit, even Cuddy realizes something is seriously wrong with House, and once again it’s up to Wilson to help. In the midst of all this is the patient - a man with a brain split in two to deal with his frequent seizures who suffers from alien hand syndrome. However, could it be that the independently acting hand has known the right answer all along?

In addition to ending the Amber hallucination Story Arc, the episode explores a theme common in the series - the struggle between the rational and the intuitive. House, as always, treasures his rational self and often dismisses his irrational and intuitive side as only being an impediment to his work and the operation of human society as a whole. He's even convinced his team, particularly Eric Foreman (who carries this belief into Season 8) that he is the complete rational human being. However, one of the clearest presentations of dramatic irony throughout the series is how false this front is. Wilson knows better - House is the ultimate man child, a lover of all things dangerous. However, Wilson also knows why this is the case and House's recent infatuation with Lisa Cuddy only brings this into sharp relief - House, who can absorb as much abuse as he dishes out, can only be hurt by those he's emotionally attached to.

The patient in the episode once again respresents a part of House, in this case House's recent dealings with the Amber hallucination that functionally separated his rational, conscious mind from his sub-conscious and more intuitive self. Although at the beginning of the episode, it appears that House has resolved this issue, at the end, the plot twist is that his delusions have actually increased despite the temporary absence of the Amber hallucination. House and the patient manage to interact with the "real" world while maintaining two different realities. Ironically, it is the intuitive that consistenly wins out as both diagnoses reached are based on the intuition of the characters rather than their rational analysis. This should hardly surprise anyone as House, despite his rational analysis, comes up with his best idea not at the whiteboard, but while chatting with Wilson about something totally unrelated.

As such, the episode starts to explore a lot of "twinned" themes that we have often seen in House, such as the constant struggle between the rational and the intuitive, the struggle between what we should believe and what we want to believe and, thanks to Cameron and Chase, the struggle between letting go of one's past in order to have a chance at a future. At the end, the Chase and Cameron manage to reconcile their differences, while House realizes that he can't do it on his own.


An obnoxious patron at a restaurant gets hit by dinner rolls each time he complains. Dining next to him is a couple named Scott and Annie. Scott pushes their basket of rolls away and holds down his left wrist. Scott is also complaining that he can’t taste the spices in his food, although Annie thinks it’s very spicy. The obnoxious man assumes it was Scott who threw the rolls at him, so he confronts him. Scott apologizes and offers his right hand to shake hands, but his left hand pours a glass of water on the guy's pants. As the man grabs Scott, a tear of blood runs from Scott's eye and down his cheek.

House wakes up in bed, unusually happy. Gazing in the bathroom mirror, he sees a lipstick stain on the side of his face, and he finds a tube of lipstick on the counter.

In the emergency room, Taub and Cameron review Scott's file. The patient had his corpus callosum cut to correct seizures, but he has had some difficulty adjusting to a split brain. Taub and Cameron visit Scott, who explains how his left hand sabotages him. Taub mentions her upcoming wedding to Chase, and Cameron says that there has been a "glitch in the plans."

House arrives at the office in a good mood. Taub tells him that the patient has alien hand syndrome. The right hemisphere of the brain, which controls the left side, is misbehaving. They discuss the functions of the right brain, which is more creative. Cuddy enters and needs to talk to House alone. They go to his office and she reminds him that she his boss. Cuddy says that he can stay only if he behaves. House responds by looking at her lipstick in his hand.

House goes to Wilson to report that he slept with Cuddy and that she helped him detox. All Wilson can say is "Wow!" twice. However, House tells Wilson she is backing out. He urges House to talk to her.

Thirteen and Taub search through the patient's tiny bathroom and they find fungus. She lets slip that sperm is what is causing the glitch between Chase and Cameron. Later, Taub approaches Chase in the cafeteria and asks about Cameron saving her dead husband's sperm. Evidently, the word has spread. Chase thinks Cameron isn't ready to commit to him.

House takes infra-red photos of Cuddy when she arrives in her office.

Meanwhile, Annie brings Scott his personal items. His left hand grabs a bottle of deodorant and throws it against the wall. Thirteen enters with anti-fungal medicine for Scott to take orally. Annie leans in to kiss him goodbye and his left hand smacks her. She hurries out, and as he goes after her, he falls to the floor. He can't walk.

House suggests that a meningioma could be growing a connection between Scott's two brain sides. They can test for that.

House shows Wilson two photos of Cuddy to prove that she is heated around him—it must be love. House needs to know whether Cuddy was lying to him last night or today. House wants Wilson to talk to Cuddy about it. Wilson advises him to act like an adult if Cuddy matters to him at all.

Scott is in an observation lab in front of a large computer screen with a plus sign in the middle. Foreman tells him to focus on the plus sign. Any image on the far right will be seen by the left brain, and reverse for the right brain. Scott reads off the words on the far right. He misses the word that appears on the left. Although he did not see the word 'candle,' he is able to draw a candle when asked to draw a picture of what he saw. There is no communication between the hemispheres. They flash 'stand up' on the left screen and he stands up, making an excuse for doing so - that he is cold. As House and Taub argue about the need for a right hemisphere, House notices the patient is really cold. House smells ammonia on Scott's breath and sees that he is itching, which means his liver is failing.

House enters Cuddy's office where she and Wilson are working, and he asks for approval of a liver biopsy to test for sarcoidosis. She agrees immediately because it's a safe test and accuses House of wasting her time. House puts his coffee cup on her desk. After bickering with Cuddy about clinic hours, he picks up her cup instead and walks out.

Taub and Thirteen prep for a liver biopsy to check Scott for sarcoidosis. He apologizes for his sweat and body odor, and his left hand pushes the ultrasound wand away. Scott asks for music.

Wilson confronts House about using his relationship with Cuddy as a substitute high for Vicodin. House tells him that he discovered oxytocin on Cuddy's coffee cup, a hormone used in emotional bonding. He plans to irritate Cuddy to the point where she will reveal her true feelings, or kill him in the attempt. An old man is waiting in the doorway to House's office. Cuddy sent him. The man is from the clinic and tells House that he squawks like a parrot and his wife can't stand it. However, the man can't duplicate the noise exactly.

Scott's two hands are tested as he plays air guitar to the song "China Grove," by the Doobie Brothers. Thirteen notices splinter hemorrhages under his fingernails. Suddenly, Scott vomits up blood. In the team meeting, Foreman suggests a clotting issue. Thirteen says that they already put him on heparin and his heart echo was fine. The patient also tested negative for Factor V Leiden, proteins C and S. They tell House about the patient’s excessive sweating House comes up with pancreatic cancer and orders a scan of Scott's pancreas.

Cuddy is meeting with wealthy philanthropists when the old man, sent by House, brings in a bag containing his stool sample. Meanwhile, Scott is packing up to leave the hospital. Annie broke up with him after he hit her. Taub and Thirteen try to convince him that he needs to stay. Scott gets angry and throws the deodorant against the wall again. He left hand unbuttons his clothes, because his right brain seems to know that he needs to stay.

Cameron talks to House about her dilemma. He thinks she should get rid of her dead husband's sperm. This frightens Cameron because of her doubts. Taub comes to have House check on Scott. However, House stops to get Wilson. He wants Wilson to try to talk to the patient's two fighting brains like a relationship counsellor to get the two hemispheres to work together.

In the control room at Scott's MRI, Wilson talks to the patient over the microphone. Taub says that the scan is clean; there is no pancreatic cancer. Wilson suggests stating out loud what he plans to do.

Back in the office, the old man calls House on his cell phone to do the squawk. Cuddy gave him House's private cell phone number. House hangs up to get back to the differential. Taub suggests lymphoma but House insists on the pancreas but it might be too small to spot. He wants to try a new procedure that paints infrared onto cancer cells. Foreman points out that the procedure could make the clots worse. Thirteen warns that Scott's brain MRI showed narrowing in the blood vessels and shaking a clot loose could kill him. On the other hand, Taub notes that killing one hemisphere may improve his condition.

Scott is conflicted with himself over doing the procedure. Chase and Foreman perform the surgery on Scott as Cameron comes in to talk to Chase. She says that she wants to be with Chase, and she will destroy the old sperm. However, the procedure finds no cancer and the patient’s blood pressure is dropping

Wilson catches House in the lobby. He wants to know if House really wants Cuddy, or is this just another challenge. House accuses Wilson of being afraid that House won't need him anymore. Wilson tells him if he's serious he better do something or one of them will get hurt. Below them from the balcony, a Pirate Stripper follows Cuddy as she leads him out the hospital door. Yet House is displeased because Cuddy isn't angry. Suddenly he realizes something.

As Scott's surgery continues, his blood pressure continues to fall. House walks into the gallery and tells Foreman that the clots are not from cancer. They are from the heart. If they are caused by an intermittent arrhythmia, then they missed it. He wants them to do a transesophageal echocardiogram. They find that the left atrial appendage is damaged. However, they still have to figure out what damaged his heart.

The team throws out various causes of the blood clots. Thirteen suggests Cushing's, and House tells her to run a dexamethasone suppression test. After the team leaves, House examines the coffee cup that he stole from Cuddy.

Taub and Thirteen are tending to Scott when Annie walks in the room. She thinks maybe the deodorant she had brought to him caused his anger, and perhaps it has meaning. Scott did throw it out again with his left hand when he was packing up. Scott explains that he has to use it often because it is an extra strength formula. Taub and Thirteen will look into it. Scott moves his left hand up to Annie's face and touches it lovingly.

House brings the coffee cup to Wilson, wondering why there is no lipstick on it when clearly Cuddy was wearing it. Wilson says this is not a medical case to analyze. If he can make Cuddy really angry, then it will help because they will open up. He accuses House of not trying hard enough.

Meanwhile, Chase asks Cameron if she truly wants to destroy the sperm of her dead husband. They realize that she does not have doubts about Chase. She just doesn't want to lose the last remainder of someone she loved. He tells her she doesn't have to get rid of it. She breaks down in tears and tells him she didn’t even make any attempt to cancel their wedding plans.

From the lobby balcony, House announces to the crowd in the hospital that he and Cuddy had sex. Cuddy is finally angry.

Cuddy finds House in the hallway and she‘s livid. When he suggests they move in together, she fires him, which isn't what House expected. The old man from the clinic, waiting in House's office, tells him that he thinks Cuddy likes House. House informs him that he has acid reflux and writes him a prescription. However, he notices that the old man's belt makes his belly sore. House examines him and he has a large tumor on his pancreas, and this is why House thought of pancreatic cancer for Scott. Taub reports to House that Scott's deodorant is high in propylene glycol, which caused the seizures and heart problems. The operation to split his brain was probably unnecessary. House asks him to take the old man to radiology for a pancreatic scan.

House enters Cuddy's office as she is prepping for a presentation. He asks her about the other night, yet they are talking about two different things. Cuddy is angry that House had said for her to "Go suckle the little bastard child who makes you feel good about yourself." House's version had them coming together to detox him. In reality, she had just walked out of her office for the night and he never told her about his problem with Vicodin. House is confused. None of what he remembers actually happened—no detox, no sex with Cuddy. He reaches into his pocket to show her the lipstick, but when he uncoils his hand it is really a bottle of Vicodin. He thinks back and realizes he spent the night alone taking Vicodin, and he imagined the Vicodin bottle was Cuddy’s lipstick. Cuddy becomes concerned about House. House hallucinates Amber hallucination and Kutner hallucination speaking to him.


"No. I'm not okay"- House admitting to Cuddy that there's something wrong with him.

As this happens, House then looks at Cuddy and admits to her that he is not okay.

Cuddy then brings House to Wilson's office.

As they enter, Wilson gets to his feet, concerned and having quickly realized that there's something wrong with House.

While the rest of the team is attending Chase and Cameron's wedding, Wilson drives House to the Mayfield Psychiatric Hospital where House admits himself.

Major Events Edit

  • It's soon revealed that House's supposed detoxing from Vicodin and his night with Cuddy were all merely hallucinations.
  • Chase and Cameron finally get married.
  • Realizing he's on the verge of losing his mind and also suffering from psychosis, House presumably temporarily resigns from his position at the hospital and then enters Mayfield Psychiatric Hospital to get help.

Zebra Factor 6/10Edit

Propylene glycol is usually a very safe substance. It is commonly used as a solvent in pharmaceuticals and as a food additive and is only toxic in large quantities because it breaks down in the body very quickly. It also is very safe when applied to the skin - it doesn’t cause irritation or allergies. It is commonly found in disinfectant hand cleaners. However, it can be dangerous to some individuals if it is inhaled, although most people are not bothered by it.

Trivia and Cultural References Edit

  • The title for this episode is from the Joni Mitchell song Both Sides, Now. It might refer to any of these plot elements:
    • At the end of the episode, House realizes the reality of what happened when he had thought he had spent the night with Cuddy, seeing "Both Sides Now".
    • By the end of the episode, the main patient has gained control over his left arm, more in-sync with "Both Sides Now".
    • By the end of the episode, Chase is able to understand Cameron's point of view in regards to her previous husband's sperm.
    • That although House thought he'd learned something, once his hallucination has ended, he realises, much like Mitchell in the song, that he hasn't learned anything more about his life, and still doesn't fully understand it at all.
  • Wilson has replaced one of his movie posters and now has one for Ordinary People, which won the Oscar for Best Picture in 1980.
  • The song House sings to himself as he remembers his night with Cuddy is The Trolley Song from the musical Meet Me In St. Louis.
  • The Phillies are the Philadelphia Phillies, Philadelphia’s Major League Baseball team.
  • House’s remark to Eugene about “nice pants” is a reference to how high he wears the waist of his pants. As men age, their belt line tends to rise on their torso and often comes up well beyond their navel.
  • The song Scott's left hand plays to during his tests is China Grove, a single for the Doobie Brothers in 1973. It wasn’t a hit at the time but has proved to have “legs”.
  • Led Zeppelin is a British rock band formed in 1968 that is best known for its song “Stairway to Heaven” which, although never officially released in the United States, was nevertheless the most requested song for radio airplay during the 1970s.
  • Kal Penn was too busy to film for the episode, so his "appearance" was taken from discarded footage from a previous episode.
  • The song at Chase & Cameron’s wedding is As Tears Go By by The Rolling Stones, which was first a hit for them in 1965. The fully instrumental version played at the end of the episode is by the Vitamin String Quartet
  • Mayfield Psychiatric Hospital was actually the largely abandoned Greystone Park Psychiatric Hospital in Parsippany-Troy Hills Township, New Jersey. The House crew was reported filming there prior to the release of the episode. More about Greystone Park - until The Pentagon was built, the hospital had the largest building foundation of any building in the world. Woody Guthrie was treated there when he was suffering from Huntington's disease/
  • This episode features a second reference to the Bombing of Dresden. The first came in the Season 5 episode The Greater Good


This is one of the best reviewed episodes of House M.D..'s users gave a 9.1/10 score, making it their ninth best rated episode of the series. However, many of the episode's initial reviews were mixed. Many were offput by the fact that most of House's perceptions during the episode were based on a delusion - a plot device that had been used in several other episodes. However, many believed the last ten minutes of the episode contained some of the best storytelling and acting in the series.

  • IMDB users rated the episode a 9.7/10
  • Polite Dissent gave the plot an A, but the medicine a B and the final solution a C.
  • The Onion A.V. Club gave the episode an A-.



Dr. Lisa Cuddy: [to House] People who get close to you get hurt, that's a fact. You're a valued doctor at this hospital, that's another fact. From now on, I'm going to focus on the second fact.

Dr. Gregory House: I slept with Cuddy. After she helped me detox from Vicodin. I've been clean for almost 24 hours.
[Wilson stares at House]
Dr. Gregory House: Okay, thought I'd mention it.
Dr. James Wilson: Wow. Wow! One for each.
Dr. Gregory House: That's what she said "Haaa."
Dr. James Wilson: How's the pain?
Dr. Gregory House: She's probably got some bruising.
Dr. James Wilson: Yeah. I get it. You're a stud. This is serious, House.

Dr. James Wilson: Wow. This is fantastic! How are you going to screw it up?
Dr. Gregory House: Several good options. Unfortunately, I don't think, she's going to give me the pleasure. She left before I woke up. 5 minutes ago she told me I'm just an employee.

Dr. Chris Taub: So your left hand would rather play air guitar than give me a hard time?
Scott: Rather play air guitar than tie shoes, eat dinner...
Thirteen - Dr. Hadley: Your right hand's playing too.
Scott: Don't want to discourage it.
Dr. Eric Foreman: [Meeting in the locker room] Why aren't we in the office?
Dr. Gregory House: I'm tired of clinic duty.
Dr. Chris Taub: You're not going anywhere. Unless you want to go naked. Your right brain knows you need to stay.
Scott: My right brain's an ass!

Thirteen - Dr. Hadley: His brain MRI showed narrowing in his blood vessels leading up from the neck, if we do shake something loose, we could kill him.
Dr. Chris Taub: Or one of them. Clot in his brain could kill one of them, without affecting the other.
Dr. Eric Foreman: He might actually be okay with that.

Dr. Gregory House: You're worried that once I'm in a relationship, you and me will be over.
Dr. James Wilson: Hey, I'm actually *for* this. I think this is great! But if you're serious and you don't treat it seriously then you will get hurt. And if you don't accept that, then accept that she will get hurt.

Dr. Chris Taub: [Watching Scott's left hand gently stroke Annie's face] Somebody's grateful.
Thirteen - Dr. Hadley: We'll just leave the three of you alone.

Dr. Robert Chase: You don't have doubts. You just don't want to kill the only thing left of someone who loved you.
[Cameron starts crying and they hug]
Dr. Robert Chase: Don't do it.
Dr. Allison Cameron: I do have trouble giving things up. For example, [Cameron starts laughing] I never cancelled our wedding plans.

Taub: What do you think of this glitch with Chase and Cameron's wedding?
Thirteen: It's always a sad thing when sperm comes between people...

Dr. Lisa Cuddy: Are you okay?
Dr. Gregory House: No. I'm not okay.

House: I paid the guy in the gym to retrieve one of her water bottles from the trash.
Dr. Wilson: Love inspires us to greatness.
House: So, I need to make her lose her temper. Which breaks her delusion which demonstrates to me and to her that there is something underneath this facade.
Dr. Wilson: And then what happens? She admits everything and falls into your arms?
House: That's outcome one. Outcome two is she kills me. I think it's 50/50 right now.

Dr. Wilson: Cuddy is not a Vicodin substitute.
House: Quite the opposite.
Dr. Wilson: You have to wait for her to be ready.
House: Great advice. You pretend that I'm gonna do that.

Dr. Wilson: The other wow. You were sober. She was sober.
House: Clean and sober and hot.
Dr. Wilson: Wow! This is fantastic. How are you gonna screw it up?

House: Admit it—you're curious why I want to make her angry.
Dr. Wilson: I'm sure it's convoluted, wrong, and stupid.

Dr. Wilson: Why is it always reasonable in Houseland to take an emotional problem and sidestep it by turning it into a mechanical problem?
House: Because in Houseland—and the rest of the universe, by the way—when a question presents itself, it calls for an answer.

House: Where would junior high be without our ability to judge people on aesthetics?

House: It's a universal daisy chain of peace and love that throws buns at people.

House: Isn't that locking the barn door after the horse has put his face between your breasts for an hour and a half?

House: Her lips say no, but her hormones say "Oh my God, yes, more."

House: That's the breakfast of relationships; most important one of the day.

House: I'm sorry, I'm about to lose you because I'm about to drive into a tunnel in a canyon on an airplane while hanging up the phone.

House: Three wives. And as soon as you build them up to be well, as self-sufficient as they were ever gonna be - they drift out of your orbit. And you get sucked over to a planet with needier gravity.

International Air DatesEdit

  • United States - May 10, 2009 (Fox)
  • Canada - May 10, 2009 (Global)
  • Australia - May 20, 2009 (Channel Ten)
  • Poland - November 25, 2009 (TVP2)
  • Netherlands - December 3, 2009 (SBS6)
  • Slovakia - December 15, 2009 (STV1)
  • Hungary - March 3, 2010
  • Germany - March 30, 2010 (RTL)
  • Czech Republic - April 28, 2010 (TV Nova)
  • Sweden - October 26, 2010 (TV4)

In other languagesEdit

  • Latin America: Ambos lados, (the literal translation of "Both Sides". The word "Now" has been eliminated).
  • German: Nichts geht mehr, (the literal translation of "Nothing works anymore". This title is very different from the English version).
  • Spain: Ahora los dos lados, (the literal translation of "Now the two sides". However, Both Sides Now is an acceptable translation).
  • Hungarian: Mindkét orcádat (literally: "Both of your cheeks" - from the biblical phrase "turning the other cheek").
  • France: La Stratégie de l'inconscient (literally: "The Strategy of the Unconscious")
  • Quebec: Parle avec elle (literally: "Talk to Her")


  • The two rolls thrown at Warren come from two completely different angles. It would have been impossible for Scott to have thrown both of them.
  • The team suspects brain involvement, but never bothers to review either MRI or CT scans of the brain.
  • Liver failure progresses much more slowly than what is depicted. There is no possibility the team would have missed varices and caput medusae during a physical exam and then have them occur when they did.
  • Although inhaled propylene glycol can cause several kinds of arrythmia, it doesn't cause atrial fibrillation.
  • When the patient crashes in the operating room, no-one there thinks to look at the cardiac monitors.
  • Propylene glycol poisoning was still a big zebra when they thought of it. Many other causes of Scott's symptoms would have to be ruled out first.
  • Although Scott was bleeding from esophageal varices and coughing up blood, they still gave him blood thinners.
  • Taub's suggestion of a subconjunctive hemorrhage for the bloody tears was extremely unlikely.
  • Cuddy fired House, except he has tenure so she couldn't fire him without 100% board approval.

End Credits MessageEdit

Male Announcer: Tonight the stakes are hired, and the threat is darker. 24 is next.


This article is also available in Spanish at es.dr-house.wikia [1]

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