That certainly was an interesting episode. This is by far the greatest deviation from the normal format and I was really surprised only 2 regulars were seen (Hugh Laurie and Robert Sean Leonard). In terms of production, acting, and writing, the episode was amazing. Hugh Laurie was unbelievable through the twists and turns of a mental institution. There was no medical case other than some random music box stuff which I found pretty stupid and unnecessary. There has to be better ways to show House being helpful. Other than that, the episode was very multifaceted, touching on House, the patients, and the guy who runs the hospital.
The opening was highly impressive and there were no credits which according to Wikipedia hasn't happened since season 3. I though the episode dragged on a little too long and could have done better condensed into and hour and a half. An hour wouldn't do justice, but 2 hours was a little too much. After a while, I just wanted House to run off. Screw character development!
The funny thing is that the 2 hour episode was designed specifically to give House growth as a person which included interpersonal relationships. We know this is heading down the path of Huddy as much as some people would like to disbelieve. He meets Lydia, sister-in-law to a deaf patient. They connect over music initially and growth pretty close. Eventually House sleeps with her. Almost immediately after, she moves away after her sister-in-law is cured by House. Talk about a double-edged sword. House is pretty upset about it, he probably never got upset when the hookers left, so he shows he actually cared for someone which is almost unprecedented.
House's rapping roommate Alvie was awesome. I don't know if it was his manic condition, but could you not love him? His optimism and exuberance shone through the dregs on the blue tinted hospital. His rebellion against authority compounded with helping House and then hating House for giving in was hilarious. It would be cool to see Alvie in Princeton-Plainsburo someday and we'll see whether his personality is when he's regular. There's this crazy guy Steve who thinks he's a superhero. House tries to help him realize his dreams, but Steve ends up jumping off a parking structure. House feels bad about this when he normally would not which is another sign he's changing.
Dr. Nolan is House nemesis who turns into a friend. Initially, House tries to go to easy way out with blackmail and causing general mayhem, but Nolan knows House like the back off his hand. House can't do anything other than to play ball which he eventually does. They have some nice conversations which reveals a little about both of them.
Notice how in the beginning I never indicated whether or not I thought the episode in its entirety was good. As an episode of 'House,' I didn't particularly like it. It just was not my cup of tea. I like House for the fast-paced medical mystery and House's interactions with everyone. For a one time deal, the episode was certainly good, but I would not want to see. I like how the show always maintains a sense of normalcy from episode to episode, and while House did show significant growth in this episode, there was a surreal nature to it which made it feel weird.