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The case facing the doctors involves a foreign head of state, Dibala (James Earl Jones) who appears to be vomiting blood. Cameron has issues with treating Dibala because he is being accused of genocide and crimes against humanity. Based on some of the things Dibala says, it’s clear that the accusations are true. Cameron would rather have him dead than treat him. Chase, meanwhile, wants to do his duty as a doctor.
Foreman, meanwhile, is trying to patch things up with Thirteen, after firing her in the previous episode ”Epic Fail”, using the excuse that he did it to save their relationship. She’s not buying it, though. After she agrees to meet him for dinner, and after she questions why Foreman didn’t decide to step down rather than fire her, she comes to the conclusion that Foreman was going to put his needs and wants first, and she walks out on him.
House can’t get directly involved with the patient, but he is able to give the staff advice on how to treat Dibala. In a scene perfect for the acting talents of Hugh Laurie, House communicates to his staff using facial expressions and hand signals. It was the first time in a long time that I genuinely laughed during an episode of House.
House is also stirring the pot at Wilson’s apartment by getting into it with Wilson’s downstairs neighbor, a Vietnam War vet missing his hand/arm. The tenant is a cranky as House for the same reasons – he feels unending pain. In the case of the tenant, it is a phantom limb. The tenant is sick and tired of hearing the constant noise from House’s cane as he walks in the apartment above, and is also sick and tired of the cooking smells, and he wants House out. House thinks that he can intimidate the tenant to back off. The plan backfires horribly when House’s attempts to expose the man as a fake Vietnam vet is foiled by the fact that he really is a vet - a Canadian vet who had been sent to Vietnam to uphold the peace. The man is in horrible agony from pain in his hand/arm that he no longer has. Despite the fact that House still has his own leg but suffers from pain, he seems to develop sympathy for this man.
Meanwhile, treatment continues on Dibala’s mystery illness. Chase is approached by a man, Ruwe (Garikayi Mutambirwa), who wants Chase to forgo curing Dibala because of his killings of their people and explains how Dibala’s government is guilty of rape and torture of his own wife. Later, when Chase sees Ruwe approach Dibala’s room disguised as an orderly, Chase warns the guards and an assassination attempt is foiled and Ruwe is beaten. When Chase chastises him for his actions, he tells Chase he lied about having a wife who was attacked; rather he was made to torture women by Dibala's soldiers. He impresses on Chase that worse things will happen to the people of his country at the hands of Dibala, and a massacre is coming.
Cameron isn’t thrilled that Chase warned the guards that Ruwe was coming. Later, she uses an opportunity where Dibala seems to be confused in the head and she tries to implant an idea with his chief advisor that he may never know when Dibala will be able to give commands with a sound mind. It’s clear that Dibala was later made aware of this, when he confronts Cameron as she was about to inject him with a drug to treat him, saying all she needs to do is inject an air bubble and he will be killed. He knows she wants him dead but he tells her if that’s the case she should do it herself. Of course, she doesn’t, but something in Chase’s mind has already clicked over to the “dark side.”
During their assessment of Dibala, House thinks he has Scleroderma, but Foreman thinks it is Blastomycosis, and he tells Chase and Cameron to treat Dibala as such. Later, Cameron asks for a blood test that seems to confirm House’s diagnosis of Scleroderma, and she convinces Foreman into changing his mind and treating Dibala with steroids.
Meanwhile, House manages to knock out the neighbor by injecting him with some drug, and then restraining him with duct tape, covering his mouth as well. When the neighbor comes to, he is terrified, and one can only wonder if House has gone off the deep end. But there is a method to House’s madness. He has the neighbor place both arms into a box with a mirror, giving the illusion that he has two arms. (Mirror therapy is used often to reduce phantom limb pain.) After getting the neighbor to squeeze and release a fist, House relieves the man's phantom pain for the first time in decades. The man is grateful to House. Later, Wilson is suspicious when the neighbor has no further problems with House and as an added bonus, approved a request for an upgrade of the facilities’ garden.
Back at the hospital, problems ensue when Dibala begins to bleed through his lungs and dies. Foreman is dejected over the event, and he wonders if House’s diagnosis was correct. House tells him to go to the morgue and find out. When Foreman can’t get access to the body, now under guard, he finds that Chase had signed in to the morgue earlier in the day and questions Chase about it. He knows that Chase was there to draw blood from another patient who had Scleroderma, and gets Chase to admit that he drew that blood to be tested to provide a false diagnosis for Dibala. Foreman is horrified that Chase essentially has killed Dibala, and he thinks Chase will have to answer for it. Chase just asks that Foreman give him some notice before he gets the police involved.
Later, as Dibala’s son grieves over his father’s body, we see Foreman burning the paper which is the evidence that Chase has been in the morgue earlier that day.
Despite the ending, this episode was comfortable, like the episodes of previous seasons where the old team was together. House seemed more relaxed, though, yet he still kept his slightly darker side with his rather unusual treatment of an unwilling patient, Wilson’s neighbor. But is House correct in his assessment that Foreman and he are alike? There are some aspects where they are – they both seem to enjoy being in positions of power and authority. They are different in the fact that House would probably not dump the woman he loved in order to advance his own career. Foreman wouldn’t tie someone up with duct tape to cure him or her. Would they both cover up a murder at the hands of one of their own doctors? Hard to say. Clearly, Foreman is motivated to do so not because he feels for Chase, I believe he is doing it to cover a murder that happened under his watch. Foreman is insecure and likely thinks that the discovery of Chase’s actions would reflect badly on him and his future. House, on the other hand, doesn’t have to worry about his standing in a leadership role as he’s gone through drug addiction and rehab and the hospital still wants him back. I also think House would have probably found his own way to kill Dibala if he felt it was the right thing to do – and without living an obvious trail.
All in all, this was a fantastic episode which brought the team back, but only to create a sticky problem that, according to the previews, will come back to bite them. While the title of this episode was called “The Tyrant” we saw more than one of them – Dibala, Foreman, Wilson’s neighbor. Two of them were changed during the course of the show – Dibala is dead, Wilson’s neighbor is cured. Foreman doesn’t seem to have changed at all, and I don’t suspect he will, any time soon.
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