'What's My Necklace Made Of?': House, M.D.'s Best Twist Explained - SlashFilm (2025)

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Medical dramas like "M*A*S*H" and "The Pitt" make for incredibly compelling television. Whether cases are seemingly straightforward, and the doctors are just doing their best to treat their patients, or things are a bit more complicated, there's always an element of life-or-death danger and at least a bit of medical mystery. The hit Fox series "House, M.D."took the medical mystery idea a step further, following brilliant-but-troubled diagnostician Dr. Gregory House (Hugh Laurie) as he tries to figure out the cause of a different patient's medical maladies each week. Built like a police procedural but with doctors instead of cops, House was Sherlock Holmes with a stethoscope, and that led to some truly incredible plot twists over the show's eight seasons. There was one truly absurd reveal near the end of season 4, however, that absolutely took the cake.

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The two-part season finale was one of the most complicated and emotionally resonant things the show had ever done, following House after he survives a bus crash and comes to believe that someone on the bus had an illness he was about to diagnose, setting him on a race to find them. At the end of the first half, the aptly titled "House's Head," audiences discovered that things were much more serious than they seemed. One character's piece of jewelry actually revealed that a beloved character was the one dying, and things only got more tragic from there. "House's Head" andits follow-up, "Wilson's Heart," were two of the best episodes of"House, M.D.," and it all hinged on a necklace made of amber.

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Most episodes of "House, M.D." followed its namesake around the fictionalPrinceton–Plainsboro Teaching Hospital (PPTH) in New Jersey; there, he worked with a team of highly specialized doctors to solve the most obscure medical mysteries. "House's Head," however, was different. Not only was the patient's identity a mystery, but a great deal of the episode also took place in House's head as he tried to remember the moments leading up to the crash. Eventually, he pushed himself into cardiac arrest using unconventional pharmaceutical tactics to try and jumpstart his memory, which resulted in him having an epiphany as he's being resuscitated by his teammates.

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There's a woman on the bus in his memory who looks out of place. She's dressed too nicely, and when House tries to question her, she responds with a question for him instead: "What's my necklace made of?" He looks down to her necklace, a loosely rectangular pendant of beautiful amber, and realizes the truth at last: The mystery patient is Dr. Amber Volakis (Anne Dudek), the girlfriend of House's co-worker and best friend, Dr. JamesWilson (Robert Sean Leonard). Amber was in truly dire condition at another hospital, and it looked like even House might not be able to save her. Wilson was the Watson to House's Holmes, so Amber's fate had the potential to change their entire relationship.

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The second half of the finale, "Wilson's Heart," focused on House and the team as they tried desperately to save Amber, who is suffering from mysterious symptoms that complicate her injuries from the bus crash. In the end, Amber doesn't survive, leading to one of the most tragic moments in the show's history (along with KalPenn's Dr. Lawrence Kutner dying by suicide). The death drives a wedge between House and Wilson that lasts for some time. It even heavily impacts the following season, as House had romantic feelings for Amber that Wilson knew about. (Not to mention how odd it was Amber was even on the bus with House at all.)

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Amber was initially one of the season 4's fellowship applicants, and though she was not awarded one of the three fellowships, her relationship with Wilson meant she was still a fixture around the hospital. She seemed to intimidate House a bit and he called her "Cutthroat B****" as a nickname because she could be rather cutthroat. Still, there was an odd affection there as well. Eventually, Amber started to appear to House as a hallucination after Kutner's death, serving as his guilty conscience and tormenting him "from beyond the grave."

The success of shows like Max's "The Pitt"show that people's love for medical dramas hasn't changed at all. Even so, I'd be shocked if that series tried anything as wild or weird as the devastating reveal of "House, M.D." and the amber necklace.

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