Is it late enough now that this doesn’t count as a House spoiler? Probably; the episode’s already been everywhere, and even has a political angle to it. If you’ve already seen the episode or have already been spoiled, Click to read about why last night’s House played out the way it did.
One thing that interests me is that Fox’s promotion for the episode, while it did not use the actual term “very special episode,” was essentially a VSE promotional campaign, promising us that something incredibly important and shocking would happen on the episode. (I consider “shocking turn of events” to be a VSE; others argue that only a big-issue episode is a VSE.)
Another thing about the episode was when the Shocking Twist occurred five minutes into the episode. Sometimes an episode will delay the Shocking Twist to a climactic point in the episode, like midpoint or the end, but putting it right at the beginning is probably fairer to the audience that’s witnessed the promo and wants to know what’s going to happen. Also, for a show like House, it’s often better to put the twist right up front because the primary interest is in seeing how the title character will react to horrifying twists (and how he feels disoriented when something happens that he couldn’t foresee).