House, Foreman and Cuddy are called to the scene of a giant crane that collapsed into a building, because apparently, there are no other better options for emergency medical personnel in all of New Jersey than a guy with mobility issues and an attitude problem and a hospital administrator. House quickly determines that the crane operator did not fall asleep on the job but passed out, and sends him back to PPTH with Foreman to be our standard mystery illness. It turns out that the crane guy has some kind of cyst in his spine, but that's not really important, because House also finds a woman trapped in the rubble, her leg stuck underneath a support beam. Cuddy and the fireman want to amputate the leg, but House doesn't think they have to, which the woman, Hannah, very much agrees with. House and Hannah bond to the point that she has panic attacks if he leaves her side and she sort of convinces him to pray with her, but when the building collapses again when they try to lift the beam off of her leg, it becomes clear that amputation is the only option. House insists that they can save Hannah's leg, and Cuddy accuses him of risking Hannah's life by disagreeing with her because he's mad at her for moving in with and getting engaged to Lucas. She tells him she doesn't love him and never will and to stop trying to ruin everyone's life because his is so empty, then heads down to convince Hannah to agree to the amputation. In the end, House is the one who convinces Hannah after telling her how his decision not to have his leg amputated caused his life to totally suck, which is fairly heartbreaking. Hannah gets to feel every terrible second of having her leg cut off, which House does personally. But at least she's out from under the building and her husband is at her side in the ambulance on the way to PPTH. House is there, too, so he gets to be front and center when Hannah suddenly has trouble breathing and be the one to diagnose her with a fat embolism, an incurable amputation complication. She dies in the ambulance, and House is pretty much destroyed and hopeless. He goes home to raid his secret secret secret secret Vicodin stash, and it's all very depressing.
But then! THEN! The writers decide we're due for a cliffhanger that doesn't have House on the brink of death/insanity/hopelessness and give us something happy for a change, and all kinds of wonderful things happen! First, Hadley asks for a "leave of absence." And she wasn't even in this episode that much! And we might never see her again! It's FANTASTIC! And then, Cuddy arrives at House's apartment before he takes the Vicodin and tells him that she broke up with Lucas because she loves House, even though she really wishes that she didn't. They kiss and leave us wondering if this will ruin the show next season or make it even better.
It's season finale time! Let's see what kind of House-torturing sadness and despair we're in for this time, shall we? Sure enough, we open with shots of House looking bloody and beat up, standing in his bathroom with a cracked mirror, a hole in the wall, and a pill bottle in his hand. Cheery! EIGHT HOURS EARLIER, the screen tells us, House walks right on in to Cuddy's office without knocking, catching her in the process of changing clothes. She doesn't really care, telling him that a crane collapsed in "downtown Trenton" as she puts on what appears to be the PPTH-logoed emergency doctor jumpsuit, made for just such an occasion as this. "Don't care," House says, thrusting a package in her hands. Despite the emergency currently going on in Trenton that supposedly requires her immediate assistance, she takes the time to open it, finding that book from last week inside. "My great-grandfather!" she gasps. "No, it's just a book he wrote," House says. I don't know why, but I found that line hilarious. On the first page of the book, Cuddy finds that House has completely ruined her chances of selling this thing off for big bucks by writing a message on the first page: "to Lisa and Lucas, here's to a new chapter. Best, Greg X." I don't know why he put an X after his name. Maybe he's thinking of changing careers to becoming a black rights activist? Cuddy waits for the fart powder House no doubt laced the pages with to take effect or the book to explode in flames or something, but House sincerely says that he wanted to congratulate her and Lucas on this new phase in their relationship. "I understand that's the adult thing to do," he says. Cuddy asks how he knew. House says he's known they were thinking of moving in together for a while now, then hopefully asks if they're having relationship issues as he helps Cuddy put her Action Cuddy Jumpsuit on. She just says she has to go to Trenton and runs out.
And we are on the scene in downtown Trenton, which looks a lot like where House had that bus accident two seasons ago. It's chaos down there, with helicopter circling, sirens blaring, and onlookers being too nosy for their own good. House rolls up on his motorcycle, because it's a really good idea for him to be here. These people just got squished by a crane. Do they really need to be personally insulted, too? He finds Cuddy, who gives him a "we are in for some suckiness" look. He follows her onto the scene, and we get a nice, long reveal of what we're dealing with. Sure enough, there is a giant crane wedged in a building. Crews work to access the buried floors and any and all people trapped inside, and this set up must have cost them so much money that they had to fire Jennifer Morrison to afford it. I feel like I'm watching an episode of ER. I don't like ER. But I'm be okay with this, as long as those circling helicopters stay in the air, far away from our main characters and their limbs.