Thanks largely due to Hugh Laurie's brilliant performance as the title character, FOX's "House" has become one of the top dramas on television. A show that owes the entirety of its ratings success to its 2005 positioning in the post-"American Idol" timeslot, it actually began outperforming "Idol" in the 18-49 demographic last season.

"House" returns for its fourth season this Tuesday, and continues to be one of the most entertaining hours on television.

Following the season three departure of his staff, Dr. Gregory House opens the fourth season on his own, albeit under pressure from boss Lisa Cuddy and friend James Wilson to hire a replacement group of fellows.

Ever the egotist, House is initially unwilling to follow their suggestion. Over the course of the first episode, however, House ultimately proves his dependency on having colleagues to rein him in. The doctor seeks help from a variety of sources, including Cuddy, other doctors in the hospital, a janitor (in a very humorous series of scenes) and even a magic 8-ball as he attempts to solve the case.

The case, that of a woman who suffers various injuries after a pipeline explosion destroyed the office building in which she was working, is one of the most effectively scripted in the history of "House." Although the suspense and emotion faced by her boyfriend and mother initially takes a backseat to the Greg House show, which features a hit-or-miss array of humor (the most notable miss being an incredibly lame plotline involving House's guitar), the conclusion to the storyline boasts a level of poignancy very rarely attained on the medical drama.

One of the biggest overall criticisms of "House" is that the cases are often half-heartedly constructed. While the tremendous acting and direction almost always emotionally hook the viewer into the action, the cases often find resolution after the emergence of a random clue or discovery; they play out fantastically as "medical mysteries" but only decently as "dramatic mysteries" (and considering the medicine is only truly significant to a small minority of the crowd, that is a flaw of the show). Rarely are the cases written as coherent storylines that introduce characters and questions before tying up loose things with a clever and effective conclusion.

This one does just that—the final revelation is shocking. More importantly, it's shocking for the right reason. The surprise element has little to do with the fact that House used a random phrase to determine the diagnosis and everything to do with compelling, suspenseful writing. Every aspect of the revelation has a root in an earlier segment of the show, with the bulk of the conclusion established in the very first scene of the show. Some viewers will predict the ending, which is actually a good thing for a show like "House," as it means that the writing was relatable enough to earn viewer investment. Instead of asking viewers to watch House do his thing, this one will truly have viewers guessing. Those who don't guess correctly will be stunned when the revelation occurs. Those who do will still be very satisfied.

Though the show truly does belong to Hugh Laurie, like the House character, viewers will soon discover how integral doctors Foreman (Omar Epps), Cameron (Jennifer Morrison) and Chase (Jesse Spencer) are to the rhythm of the show. Not one of the characters was brilliantly portrayed or especially deep, but all worked well to form a framework for Hugh Laurie's field day.

The intent of this review is not to offer spoilers beyond a general description, but it will note that the events in the second episode of the season bring the show back on track. While the season opener is a better overall episode due to the fantastic case, it's clear that "House" needs supporting characters other than Wilson and Cuddy to make the show function as an effective procedural.

Hugh Laurie develops instant chemistry with the supporting faces (to avoid spoilers) that appear in the second episode, proving how truly great he is as an actor. His ability to banter and feel comfortable with virtually anyone is what makes "House" so great; we're not just watching a great character, we're watching a great character interact with others in compelling fashion. The premise of the episode takes focus away from the case (which, despite having a good setup, becomes an afterthought by the time the episode reaches its climax), but it's still a damn good one that features a lot of humor and character development.

The return of "Grey's Anatomy" and the premiere of spin-off "Private Practice" are certainly creating buzz for the ABC flavor of medical drama, but FOX still has the better overall show in "House." The opening episodes of season four do nothing to change that reality.

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