I have to admit I didn't think ramming his car into the house was out of character - even the seeming lack of remorse in the beach scene only felt slightly off to me. Catharsis, even when destructive in nature, can be euphoric. (And I suspect that scene was as much symbolic as it was a physical reality) And while it bothered me that he walked away from a clearly injured Wilson, that didn't feel about of character either. While House has always had a self-destructive streak, he's turned it on his patients, colleagues and friends before, and he hasn't always been remorseful about it.

I may be in the minority, but I like the PotW parallels - the patients don't really mean anything to me unless they bring up a compelling ethical issue or reveal something about the characters. It might have been a bit heavy-handed this time, but I did like the way the patient/assistant relationship paralleled both House/Cuddy and House/Wilson. To me, House was talking about Wilson when he told the patient that he's left before, he'll leave again, especially since the assistant's statement that he couldn't watch her die unnecessarily was a clear callback to Wilson telling House that he can't watch him continue to self-destruct.

I'm actually much less distressed by this finale than I was last year. Pretty much what I feared about the use of Wilson as a character this season came true to an extent (it seems to me that the only thing we learned about Wilson this season is that he adopts damaged cats when he ends relationships - and that's only an extension of Wilson being attracted to damaged people/animals). Now I actually have hope that they'll be forced to do something new with him next season. And if the first few episodes are House getting his shit back together on his own, then I won't begrudge RSL a well-deserved vacation.