The classic medical drama House’s Sherlock Holmes-inspired titular main character.

Unsurprisingly, with such unusual diagnoses, a lead character who lives with substance use disorder, and highly complex storylines, the episodes get tense. The lighthearted moments come through gallows humor and snide insults from the House. However, some House episodes are overwhelmingly stressful to watch, incorporating dark storylines and tragic endings. Though difficult to watch, these episodes are some of the strongest in of writing, directing, and cinematography – making them well worth watching again.

10 “Birthmarks”

House Season 5, Episode 4

At first glance, “Birthmarks” seems out of place compared to the other episodes on the list. This specific episode of House isn’t fast-paced and doesn’t include a high-tension plot like a building collapsing or a hostage situation. Instead, the stress of “Birthmarks” comes from House’s family storyline and the parallels with the patient of the week. The titular doctor must reckon with his father’s death and the impact his dad had on shaping him.

At the same time, the patient wants nothing more than to find her birth parents, only for the doctors to learn that their actions caused her current medical issue. It’s a difficult episode of House that will be incredibly stressful to watch for anyone with negative parental relationships. There’s something sobering about the fact that House still mourns his father at the end of “Birthmarks,” no matter the damage and harm done by his father.

9 “Help Me”

House Season 6, Episode 22

“Help Me” is an extremely tense episode of House that keeps viewers on the edge of their seats the whole time, only to break their hearts. The premise of a woman choosing between her life and her leg is terrifying. Every second, she gets closer to dying from crush syndrome if they don’t amputate her leg. In addition to being emotionally stressful, there’s a threat of the building collapsing on top of the trapped woman. “Help Me” tricks the viewer by relieving the stress momentarily after they remove her leg, and she’s finally brought out from under the building.

However, the stress of watching the episode hits even worse when House discovers they waited too long, and her husband starts screaming for them to do something. Ultimately, her death and its effect on the titular doctor makes “Help Me” one of the saddest episodes of House where a patient dies, too. The ending sends a poignant message that sometimes a doctor does everything right and still can’t save a patient.

8 “Detox”

House Season 1, Episode 11

When it comes to episodes about Gregory House’s opioid use disorder, “Detox” is one of the tamer, less devastating House episodes. That doesn’t make it any less stressful to watch. Hugh Laurie does an incredible job showing the physical and emotional pain and the desperation of withdrawal. He goes through sweating, mood swings, irritability, tremors, and vomiting. His judgment wanes at many points in the episode. He even hurts so severely from withdrawal and his leg that he breaks his own hand to distract his brain.

It’s all the more upsetting to realize the difficulty and nuance of his situation. He feels like he’s stuck between two terrible options – addiction or debilitating pain – not seeing another way out. Still, it isn’t as stressful as other House episodes on the subject because the addiction hasn’t progressed in severity. Also, Hugh Laurie’s character hadn’t developed quite as much in House season 1.

7 “Airborne”

House Season 3, Episode 18

When it comes to stressful House episodes, “Airborne” wouldn’t have landed on the list when the episode came out, nor when the finale came out. However, the episode comes across entirely differently when watching it again after the climax of the COVID-19 pandemic. A palpable fear comes from watching everyone get sick so quickly. The danger of an illness spreading to individuals outside the plane feels imminent. Luckily, the engers who get sick don’t have a communicable disease, which relieves at least a small amount of anxiety while watching the House episode.

Another factor that makes “Airborne” extremely taxing is the environment in which the episode occurs. House and Cuddy don’t have the safety and security of a fully stocked hospital to help them treat their patients. They are limited to what’s available on an international flight, but somehow, they make it through the situation.

6 “Broken”

House Season 6, Episode 1

The House episode “Broken” is one of the most important episodes when it comes to discussing addiction treatment, but it’s also one of the most challenging and stressful episodes to watch. For once, it focuses entirely on House’s substance use disorder. The opening sequence alone is heartwrenching, watching him go through the severe symptoms of opioid withdrawal.

Sadly, the titular doctor doesn’t seem to realize that he needs mental health treatment, not just sobriety. He tries everything he can to get out of the hospital because he doesn’t seem to understand the severity of his mental illness. Despite the tension in the episode, it ranks in the middle of the list for the most stressful episode because there’s a degree of comedic relief. Lin Manuel Miranda’s guest role is funny, and it’s entertaining to watch him get under the skin of House.

5 “Nobody’s Fault”

House Season 8, Episode 11

From the opening, where there’s blood everywhere, it’s clear that “Nobody’s Fault” in season 8 of House is high-stress for both the patient of the week and Dr. House’s team. It turns out the two stories also heavily intertwine. The patient is experiencing psychosis, resulting in him stabbing Chase, nicking his heart. The big questions throughout the episode are as follows:

• Why the patient is experiencing psychosis
• Who will get fired
• Whether Chase will live or die
• Whether Chase will be permanently paralyzed
• Whether House should be working on Vicodin

Each question in “Nobody’s Fault” is stressful and terrifying, adding layers to the overall viewing experience. The threat of Chase dying feels real, too, because Amber’s death in House proved that the main characters weren’t safe. In addition to all these stressful plotlines, the format is also stressful, telling the story non-chronologically. Jumping around in the story creates more tension and guessing.

4 “Wilson’s Heart”

House Season 4, Episode 16

Arguably the most emotional episode of House, “Wilson’s Heart” ranks high among the most stressful episodes of the show. In this 2-episode arc, the biggest part of the tension is resolved when House figures out the answer to who has a life-threatening injury in “House’s Head.” As such, the stress in “Wilson’s Heart” comes from the knowledge that Amber could die. It’s emotional to watch the titular doctor try to save her life at all costs. It’s also hard knowing, as the viewer, that the death of Amber will wreck House’s friendship with Wilson.

However, the stress of the situation was slightly diminished before the episode for two reasons. Firstly, it seems pretty evident from the start that they won’t save her, making her one of the characters leaving House M.D. before the ending. Secondly, she doesn’t have enough build-up with Wilson for her death to feel as impactful as it could have been. Ultimately, “Wilson’s Heart” has a significant emotional impact, inducing stress for viewers, but not as much as other episodes.

3 “House’s Head”

House Season 4, Episode 15

In the best episode of House, “House’s Head,” the shots of the bus crash are stressful enough on their own to keep viewers holding their breath. Additionally, the titular doctor spends the whole episode trying to which person in the crash has a life-threatening injury. Unlike most people who feel like they’re forgetting something important, Dr. House’s memory problem could leave someone dead, giving the incident high stakes. The directing and cinematographic choices also contribute to the stress of the episode.

The momentary flashbacks occur in black and white with high contrast, and the camera tilts in different directions. The fluctuating lights and swooshing sounds during the hypnosis create an eerie mood. These visuals and sounds add drama and tension to the amnesia plotline. Adding in Hugh Laurie’s gripping performance, “House’s Head” stands out as one of the most stressful episodes of the show.

"House's Head" is House's highest-ranked episode with a 9.8 out of 10 star rating on IMDb.

2 “Both Sides Now”

House Season 5, Episode 24

When it comes to episodes centering on House’s opioid addiction, the most stressful is the House season 5 finale, “Both Sides Now.” It’s also the second-most stressful episode overall. The first half of the episode is relatively calm and tame, with nothing seeming out of the ordinary. However, the last 10 minutes are terrible enough to make up for the first half. Due to his substance abuse, the titular doctor hallucinates the following:

• Cuddy’s lipstick (actually a Vicodin bottle)
• Asking for help with his substance use disorder
• Having sex with Cuddy
• Lipstick smears on his face and cup

Sadly, he doesn’t realize any of these things aren’t real initially, but when he does, it’s terrifying. The way they cut the hallucinations and flashbacks together is unnerving. The cinematography style and closeups make the show even more anxiety-inducing. After this, he hallucinates his two dead colleagues, Amber and Kutner, who taunt him. There’s something scary about House losing grasp on reality for hours at a time. In the end, “Both Sides Now” cross-cuts scenes of the wedding with House going to a psychiatric facility, showing the devastation of House's rock bottom.

1 “Last Resort”

House Season 5, Episode 9

Most episodes of House are tense due to dangerous medical conditions or House’s addiction, but “Last Resort” is an entirely different beast. Every aspect of this episode contributes to its heart-racing and anxiety-inducing impact. “Last Resort” sets expectations from the first momentby using music and cinematography to create tension. They contrast slow motion with chaotic music. They later contrast the full waiting room with the empty waiting room. This story is stressful to watch because of the hostage situation and the threat of gun violence.

It’s challenging to demonize the man with the gun because his character arc taps into the very painful experience of desperation for medical care. He has thousands of dollars in medical debt – a reality that will hit hard for viewers in the US – and zero answers. There’s also the stress of Thirteen’s self-destructive tendencies. With all these factors and the contained environment, “Last Resort” is unquestionably the most stressful episode of House.

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