I'm Still Not Over... the heartbreaking House season 4 finale

Still crying over a fictional character’s death from a movie you saw years ago? Having trouble letting go of that one episode of your favorite series? Grieving a gone-too-soon show? We are, too — so with this column, EW staffers pay tribute to something in the pop culture world they’re still not over. This week, Chancellor Agard remembers House‘s heartbreaking season 4 finale.

Three years ago, I used this very franchise to drag House (TL;DR: Huddy was bad). But now I’ve returned to sing the praises of one of my favorite episodes: “Wilson’s Heart,” the heartbreaking-as-hell season 4 finale, which was the first episode of television to ever make me cry. Boasting both some of the show’s best writing and the cast’s best performances, this hour pushed both Dr. Gregory House (the always excellent Hugh Laurie) and his co-dependent bromance with Dr. James Wilson (Robert Sean Leonard) to the limits.

Here’s three reasons why I still think about this exceptional episode:

1. It tested House emotionally

House is a brilliant yet arrogant doctor with a Rubik’s complex, which means he prefers to treat patients more like puzzles to be solved as opposed to, you know, actual people. Unfortunately, he’s unable to take this stone cold approach in the case he’s presented with in “Wilson’s Heart.”

In the episode, House must diagnose Dr. Amber Volakis (Anne Dudek), one of the fellows he eliminated earlier in the season and, most importantly, his best friend Dr. James Wilson’s girlfriend. She and House were involved in a bus crash, and she ends up dying from her injuries and complications from a flu medicine she was on. This case isn’t only personal because of Amber’s connection to Wilson; House feels directly responsible for her death.

See, House got too drunk to drive home from a bar and called Wilson for a ride. Unfortunately, Wilson was on call, so Amber stepped up to the plate. House didn’t want her help and opted to take the bus, and Amber followed him on because he forgot his cane (R.I.P. that boss flame cane)… which means Amber wouldn’t have been on the bus if it weren’t for him. Up until this point, we’d never seen House actually feel guilty; however, he can’t avoid it here and it colors all of his medical decisions. Wilson wants to freeze her body to buy time? Sure, let’s do it! Wilson says no to a test that would involve waking her up? Well, open-heart surgery it is!

2. It almost broke House and Wilson’s friendship

House and Wilson’s friendship is the heart of this cynical Fox drama. Apart from the fact that he saves lives, the other thing that redeems House is this relationship, since James is a genuinely good and caring person. From minor trespasses to more serious offenses — like House stealing Wilson’s prescription pad, which almost landed him in jail — Wilson put ups with them all. But, this was one issue that couldn’t be laughed away. This time House’s self-destructive behavior led to the death of someone Wilson loved.

House is very much aware of what this means for their friendship. In an attempt to figure out what exactly is wrong with Amber, House undergoes deep brain stimulation to jog his memory of the night before. After finding the answer, he suffers a seizure and slips into a coma where he imagines an emotionally wrenching conversation with Amber, who died. He confesses he doesn’t want to wake up because it doesn’t hurt in this in-between world and he doesn’t want to live in a world where Wilson hates him. What makes this admission so poignant is that it’s one of the first times House really ever acknowledges how much Wilson means to him. Furthermore, House spends most of his life avoiding pain, but that’s not an option here.

When House eventually wakes up, he discovers his emotionally exhausted best friend can barely look at him. If Amber was Wilson’s heart, then Wilson was House’s, and now House has lost that — albeit temporarily. These two eventually make their way back to each other in season 5’s “Birthmarks.”

3. God, these performances

Whenever I think of “Wilson’s Heart,” I’m reminded of one of the grave injustices of the entertainment world: Neither Laurie nor Leonard ever won Emmys, although Laurie was nominated six times for the role. This was a high point for the series, one it would constantly try and sadly fail to reach again.