A single television episode can exemplify the spirit of its time. A Very Special Episode presents The A.V. Club’s survey of TV at its most distinctive.

For one night in 2005, House was the best show on television. And I’ll go even further than that. For about three years, House was an example of network TV at its sharpest. A forward-thinking hybrid of the medical procedural and the “antihero” drama, the show delivered fiendishly difficult case-of-the-week mysteries, solved by a prickly, pill-popping diagnostician named Gregory House—a character modeled directly on Sherlock Holmes. (Get it? House? Holmes?) And then on May 17, 2005, toward the end of season one, Fox aired “Three Stories,” an episode written by creator David Shore and directed by Paris Barclay, which set such a high bar for what House could be that even though the show ran for seven more seasons—and was mostly excellent for two of those—it never again realized its full potential.

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Prior to “Three Stories,” House’s first season followed a fairly rigid formula. While looking for ways to shirk work, Dr. House (played by Hugh Laurie) would be bullied or bribed by his boss Dr. Lisa Cuddy (Lisa Edelstein) into putting in clinic hours at New Jersey’s Princeton-Plainsboro Teaching Hospital, where he’d inevitably catch either a stupefying case or spot something seemingly routine that would turn out to be extraordinary. While leaving the grunt-work to his often baffled and annoyed team—Dr. Eric Foreman (Omar Epps), Dr. Allison Cameron (Jennifer Morrison), and Dr. Robert Chase (Jesse Spencer)—House would make inappropriate comments and willfully violate the medical profession’s various codes of ethics, all while bouncing ideas off of his long-suffering friend/conscience Dr. James Wilson (Robert Sean Leonard). Typically there’d also be a subplot of some kind—sometimes carried over from earlier episodes—related to hospital politics or the staff’s interpersonal drama.

“Three Stories” also starts with Cuddy cajoling House, though instead of clinic duty, she wants him to fill in for a professor named Dr. Riley, who’s out sick, and to deliver a lecture on diagnostics to a group of obnoxiously bright medical students. On his way to the classroom, in a seemingly unrelated scene, House is stopped by his ex-girlfriend Stacy Warner (Sela Ward), who explains that her husband’s been behaving erratically and that she’s desperate for a qualified doctor’s opinion. House waves her off and then heads to the lecture stage, where he sits quietly for a few minutes, apparently stewing over Stacy’s request. Then he starts peppering the class with facts and questions related to three case studies, all about patients who showed up at Princeton-Plainsboro with leg pain.

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Initially, “Three Stories” seems like a super-charged episode of House: three cases, no subplot. It’s also stylish and playful, with director Paris Barclay picking up on what the show had been doing since the Bryan Singer-directed pilot (which plunged the camera into wounds and through sick bodies). For “Three Stories,” as House jumps from case to case, the classroom environment and the flashbacks begin to bleed together, and to shift between House’s fantasy version of the case histories and how they actually may have played out.

To keep the cases generic and to honor doctor-patient privilege, House imagines the same middle-aged schlub (played by familiar character actor Brent Briscoe) as “the farmer” and “the volleyball player” in his first two scenarios, while in the third he casts Pussycat Doll and Baywatch star Carmen Electra. Eventually though, as the students ask more specific questions, the look of the patients changes: The farmer becomes less cartoonish, the volleyball player turns into a young woman, and Carmen Electra gives way to a cranky, well-dressed dude with a drug problem. Throughout, House’s class pops up in the background of the flashbacks, while his staff files into the classroom to hear how the stories end—even though they were personally involved with the first two.

All of this goofing around is partly intended to distract the people watching at home, so that Shore and Barclay can blindside them with one more switcheroo. It turns out that the third story that House is telling isn’t about Carmen Electra or some random yuppie junkie. It’s about him, and how an undetected aneurysm turned him into the limping, pained, opiate-addicted jerk that House fans had been watching for 20 episodes. This is an origin story of sorts, and one that House is bringing up now because the moment when his leg pain started was also moment when he stopped trusting his then-girlfriend Stacy, who went against his wishes and authorized the medical procedure that crippled him.

“Three Stories” was seen by nearly 18 million viewers on the night that it aired, and won an Emmy for Outstanding Writing. Shore has called it his favorite House episode, and it’s widely considered the series’ peak, and a highlight of early 2000s TV. (It’s even been the subject of an A.V. Club “TV Roundtable.”)

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But what actually sets “Three Stories” apart? And why couldn’t House match it?

First off, recognize that House wasn’t wholly original. Beyond the undisguised borrowing from Sherlock Holmes’ deduction-driven plots—a slant also common to 1970s detective shows like Columbo and Banacek—House was in a lot of ways a throwback to the kind of medical series that had fallen out of favor on American television in the era of “hospital dramas” like St. Elsewhere and ER. This show was less about the day-to-day grind of working alongside other doctors to treat a constant, at times overwhelming flow of ill folks, and more akin to the Dr. Kildare movies of the 1930s and 1940s (and the 1960s TV version), where the heroes grappled with one single confounding case at a time.

And in the early going especially, House was very much in line with the look of other circa 2005 television series about serious professionals. Whenever TV tackles cops, lawyers, or doctors, the creators can go one of two ways: grittily realistic, or absurdly abstracted. House falls more on the latter side—the CSI/NCIS side—with its glass-walled rooms and the kind of dim mood lighting that no real hospital would ever allow. Sleek sets subconsciously instill confidence in the people who work there, and they also eliminate visual distractions, so that viewers can focus on the characters. House built on that by using lighting to frame faces, to suggest something about what these people represent to each other. In “Three Stories,” for example, when Stacy’s making the decision that will change House’s life and drive him away, she’s lit to look a lot like a film noir femme fatale.

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One possible reason Shore wanted his show to prune away excessive realism is that for all its visceral effects, House was a show about issues and ideas in conflict. A lot of procedurals are “ripped from the headlines,” but House was more “ripped from a university seminar.” Throughout “Three Stories,” the doctors and students do a lot of arguing. Is it good or bad to form a personal bond with a patient, or is it better to think of them as a collection of body parts? Should doctors ignore what patients want and force procedures on them that could save their lives? If people come into the hospital looking for drugs, should they be treated the same as anyone else? House himself had a few set beliefs. “Everybody lies” was one; and another was that there’s nearly always a right answer and a right decision, even if neither are immediately apparent. At its peak, House put its audience through the dialectical wringer before revealing its version of the truth.

House also offered the pleasures of serialization that other procedurals at the time mostly didn’t. Immediately before “Three Stories”—season one’s penultimate episode—the show made its first stab at a serious “this changes everything” arc when it introduced a pushy billionaire donor (played by Chi McBride) who demanded that House make his department more efficient and less rogue. In later seasons, the hero would beat his addiction and get his leg fixed—both temporarily—and he’d weather criminal investigations, wholesale staff changes, and questionable love affairs. Sometimes the procession of House foils felt like Shore trying to give his Holmes a Moriarty. More often, the series used its running subplots and villains to explore aspects of the main character, and to fit him into a larger theme. Season one was largely about the frustrating uncertainty of medical science. Seasons two and three followed up on “Three Stories” by looking more into how House got so ornery, and whether his brilliance and his obnoxiousness were inextricably bound. Season four considered whether proximity to House had permanently poisoned his friends and colleagues. And so on.

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But with pleasures come perils. House’s major fault was that the series could only ever present incremental and impermanent change, because a well-adjusted Dr. House was a boring Dr. House. There were times when the show walked a very thin line between making its antihero too cuddly or too sociopathic. But even at its most daring, it was always just an episode or two away from scrambling back to the status quo. The real question was always whether House was sneaking complicated ideas into the slick adventures of a super-clever medical detective, or whether those ideas just added an illusion of depth. “Three Stories” even toys a little with the idea that there’s always a shallower level to House, by suggesting that after all the razzle-dazzle storytelling and secret-origin spinning—all of which could be seen as House gradually talking himself into treating Stacy’s husband—this episode might really be about our man cracking the case of why Dr. Riley misses so much class.

Even if House himself weren’t fundamentally intractable, this show likely still would’ve fallen victim to the same plague that afflicts most contemporary character-driven dramas. While the more genre-rooted Breaking Bads and Justifieds and Losts and Game Of Throneses can tell winding stories that work toward an endpoint (however satisfying or unsatisfying), House and its ilk have only have a few tricks to play. Once they’ve made all those moves, they tend to repeat them in different variations until the audience gets bored and dwindles.

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Speaking personally, I often bail on these kinds of shows after a few seasons, even if they were once among my favorites. I quit House midway through season five (then watched some of the last few episodes, for closure). I dropped ER, and Grey’s Anatomy. And it’s not just medical dramas that wear thin after a while. Desperate Housewives went from a can’t-miss to a never-again around season three. Suits went from an underrated pleasure to a miserable chore just last year. Heck, I gave up on Finding Carter at the end of the first season, even though I evangelized for it in the early going.

At a certain point, no matter how charismatic the characters or how magnetic the milieu, this same-game-different-players shuffle becomes a drag. An amoral hero tries to reform, but relapses. Characters hook up, then break up. Friends feud, because one does something untrustworthy. (Seriously, no one in the real world uses the word “trust” as often or as gravely as the people on TV dramas. It’s the weakest, vaguest, and most common way to add conflict to a show.) In between whatever episodic situations arise, these series are essentially telling and retelling three stories—and not, unfortunately, “Three Stories.”

What really makes this one House episode so exceptional is that it’s boldly self-referential without ranging too far into smartass territory. House says that he wants his students to think that “a leg is a leg is a leg,” but in every one of the stories he tells, the diagnosis demands that the doctors get to know at least enough about the patients to fix them. It’s just as easy to argue that “a story is a story is a story.” But great television requires that we care at least a little about who the story is happening to. With “Three Stories,” House came up with a deeper reason to empathize with House himself, beyond him just being the show’s title character. This was the moment when he became the real heart of the drama, pumping out bad blood.

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Next time… on A Very Special Episode: The Dana Carvey Show, “#8”