You must mean, how in the first couple minutes, somebody gets sick. Meanwhile, House is insulting somebody. The person comes to the hospital, gets repeatedly tested while other doctors think they have solved the problem, but no...House insults and abuses more co-workers AND looks pathetic now and again and flashes some eyes at Cutty. With 10 minutes to go, the certain diagnosis happens but the person gets even worse, right up to the doorstep of death...then House insults somebody, gets an "Aha" moment, orders and urgent halt to the treatment and orders a radically different treatment. By the time the commercial is ready to roll, things are good again, patient's on the mend, House is still a grouch and the world moves on.