House examines a man named Vince who was admitted with a severely swollen tongue. He asks Vince questions to get him to speak funny. In House's office, Foreman assumes it's simply a routine case and walks out. Another man named Jack comes into the office and asks for House. Jack identifies himself as a former patient, then pulls out a gun and shoots House. He asks House if he's shocked.
House wakes up in a hospital bed. Cameron is at his side. He feels his beard and can tell that he's been out for two days. His first words are to chide Cameron for waiting. She tells him that the bullet pierced his stomach, nicked the bowel and lodged into the posterior rib. Cameron tries to explain to him what Jack had to say. Yet House is more interested in Vince's tongue. Jack's bed is wheeled into House's patient room. He was shot by security when he tried to leave the hospital. House gets out of bed and starts walking to Cuddy's office.
House complains that somebody screwed up his surgery because he can no longer feel pain in his leg. Cuddy thinks this is serendipitous, but House is worried that the surgeon messed up his nervous system.
In the ICU, House lowers Jack morphine and asks why he tried to kill him. Jack says if he really wanted to kill him then he'd be dead. Jack wants House alive because he wants to see him suffer. House disconnects the man's morphine completely to torture him.
The doctors follow House's instructions and biopsy a lymph node in Vince's lower jaw. They report back that the test was negative. They cannot give Vince a lumbar puncture because of the high intracranial pressure in his head. House orders them to do the LP anyway. While performing the LP, Foreman notes that Vince's pressure becomes normal.
Jack explains to his roommate House that he had treated his wife and cured her. In the process of the treatment, House emphasized the importance of knowing everything. This caused Jack to confess to an affair. Although the affair had nothing to do with the wife's brain aneurysms, House told the wife about the infidelity. She later killed herself. House completely rejects this as an excuse.
House spots an attractive woman looking into Vince's room. He is quite surprised to find out this woman is married to the very plain and overweight Vince. House doesn't hesitate to tell her so. Having been warned about House by another friend that he had treated, the woman swats his questions easily.
Foreman and Chase discover that Vince is bleeding into his ocular orb. Chase recognizes tremendous pressure behind the eye. Before Foreman can relieve the pressure, Vince's eye pops out.
House tears his stitches while walking the hallway. He collapses with blood coming from the wound. Back in his room, House and Jack argue over who to blame for the suicide. House denies any culpability, and Jack angrily says he knows it's his fault. House admits that he's partially at fault, but once Jack pulled the trigger he lost the right to an apology.
House escapes from the hospital to a local taqueria with his team where he throws out possible causes for Vince's ailment. House wonders why Vince's eyes and tongue were affected while his nose was spared. The problem may have a common source like the brain. Although a previous CT scan proved clean, House wants them to recheck the brain for what might be hiding. They must also biopsy the blood/brain barrier which is an incredibly dangerous procedure. Chase suggests testing for STDs, but House doesn't think the wife sleeps around. And Vince certainly wouldn't stray on a wife so far out of his league. Cameron is confused because Vince is a widower who is not married.
House complains to Wilson that he might have hallucinated the attractive women. Records show that Vince has had only six visitors. House frets that he's losing his logical mind. Wilson encourages him to take two weeks to rest. House is still worried that the surgery screwed him up, and he wonders aloud why he was giving ketamine during the surgery.
House finds Cuddy and accosts her about the ketamine given to him. He wasn't given simple anesthesia but was induced into a coma. Cuddy sees that House is now walking without a limp and exclaims that it worked. This stops House cold. Cuddy says that a clinic in Germany has been treating chronic pain by inducing a coma, which basically allows the brain to reboot itself. There's a 50% chance that House's pain will never return. House accuses her of having no right to do that. Cuddy scoffs that all she did was cure him.
Vince's blood/brain test comes back negative. Yet the team found blood on the wrong side of the barrier. House wonders that, if Vince's lymph nodes are not functioning properly, where would the trash they handle go? He starts to recite a metaphor about trash and garbage cans. Chase quickly figures out that House is referring to the chest lymph which is the next closest lymph system. He heads off to take a sample. House questions how Chase answered his riddle so quickly. Jack mocks him by saying that he's getting dumber.
Cameron and Foreman come to House with the news that this latest test was also negative. Chase walks a post-op Vince to the toilet so that he can urinate. Vince cries out in pain. Chase leans around to look at what's causing the problem and blood splatters on his face. Vince's scrotum has burst. The team tries to find more possibilities. Foreman throws out testicular cancer.
Wilson tells House that testicular cancer could indeed rupture a vessel. House knows this, but is concerned that he did not think of it earlier. House becomes angry that he had to trade a good brain for a bad leg. Wilson thinks House needs his bad leg to define himself, as an excuse to always act miserable. Without it, House doesn't have himself anymore. House asks why Wilson is defending Cuddy. House notices that Wilson seems like he's known about Cuddy's decision for longer than he lets on.
House blasts into Cuddy's office and begins screaming that all he has is his brain. She had no right to put him into a coma. Cuddy and Wilson are equally angry, saying that they were only trying to help him. Cuddy complains that House's morphine use had been spiraling out of control. House punches Wilson in the face. Wilson laughs and asks House if he's hallucinating.
House comes to in his ICU bed, staring at Jack. He had been hallucinating. Jack says that he was calling him Wilson, but House denies it. Jack isn't surprised when House mentions that his hallucination involved a bathroom. He coolly informs House that he wet his bed. The team enters with a negative result on Vince's testicular cancer. House calls for a cystoscopy. It too comes back negative.
House is more interested in the fact that he can easily run up and down the stairs. He darts past the team as they throw out more possible causes. Suddenly, House stops in his tracks and asks them how he got there. He remembers being in the ICU and he remembers being on the stairs with them. He doesn't know why he's still on the stairs with them at the bottom. The team doesn't know what to say.
House tells Cuddy that he's dropping out of Vince's case. He is suffering from blackouts and fears he is losing his mind. Cuddy asks if he intends to scare her. House wants to know why she jumped up when he came in. She claims it is because of their last angry encounter, which House knows was a hallucination. Is this also a hallucination? House wakes up in the ICU.
Over more tacos, House asks Jack how he can tell what's real and what isn't. Everything seems the same. House is aware that this conversation is actually a give-and-take with his own mind. Jack explains that House is concerned that he will base his actions in the real world on fantasized information, then he can cause genuine harm. Jack advises him to take no actions until his mind has settled. He should only throw out ideas and trust his team to know which thoughts are useful and which are possibly fatal.
House learns from the team that the prostate exams also came back negative. House asks them what it means if something doesn't make sense. He makes it clear that this is not rhetorical. He needs actual help from them. House asks them very basic questions, and the team is lead down the path of surgery because the biopsies aren't telling them enough. However, Vince's bleeding problem makes surgery fatal. House asks about performing a surgery that's less bloody than a paper cut.
Cameron informs Vince that they would like to use a robot to operate on him, but Vince is resistant. Cameron explains that the robot can magnify everything ten times to let them see things they ordinarily could not see. House is forced to take him to the robotic operating room to show him. House lays Cameron on the table for a demonstration, showing Vince that the machine won't let the surgeon do anything that doesn't compute medically. He uses the scalpel to slice a button off of Cameron's blouse and the clamps to pull it open. Vince agrees to the procedure.
House works on Vince's case from his hospital room. Jack interjects that House does not care about emotions. He only cares about measurable truth. Even though he cannot measure emotions, doesn't mean they're not real. House begins to see a car with the attractive woman from Vince's room. The woman is actually Jack's wife. She has a car engine on in a closed garage to kill herself. House hears Jack's voice in his head telling him that he is miserable for nothing.
Snapped back from his vision, House apologizes to Jack. More importantly, he knows what's wrong with Vince. House walks into the robotic surgery and tells Cameron that Vince will be fine. House asks the team why they haven't yet tried to yank him off the case. They say that they trust his judgment and have worked with him long enough to know what he wants. House asks why they have identical knowledge. He announces that they are all visions in his head. House seizes the robotic control and attempts to drive the scalpel into Vince's stomach. The team tries to stop him, but House needs to know if this is a hallucination. The scalpel rips open Vince's stomach and blood flies everywhere as Vince's vitals drop. House staggers over to the body. Vince drops a bullet from his hand and House picks it up.
The doors to the ER burst open. Cameron, Chase, Foreman and the EMTs wheel a bloody House through the hallway. Chase barks orders to the team that House was shot once in the abdomen and once in the neck. Before he passes out, House asks Cameron to tell Cuddy that he wants ketamine.