"I'm not doing anymore chemo." Wilson arrives at House's door at the arranged time, and House has the supercharged chemo equipment set up for his friend, but Wilson is now resigned to his fate. "Five more months on this earth is reasonable," he says. "A year in the hospital in excruciating pain is not." He won't be persuaded otherwise. Certainly not by House's best-case scenario of two-week-on, two-week-off chemo potentially delivering only two-to-three more years. "I'm not going to let you just die!" House yells to his friend.
"You know, management research shows that the best ideas come from casual contact. So, one set of season tickets. I've got the seat next to you." Foreman greats House when he arrives at the hospital with a friendly gesture, but as the first game is almost a month after Wilson is expected to pass away, House is skeptical that it's just an attempt to keep him from falling apart. "I'm trying to show you there are other people who care about you," Foreman says.
"Forty-six-year-old oncologist refuses treatment . . ." House wants to DDx Wilson, but the team is intently watching a video of Derrick, a 19-year-old cheerleader who drops a fellow cheerleader and gets a bloody nose during practice. It was Foreman's idea. "He wants us to keep things as normal as possible, for as long as possible," Adams says. With Wilson dying and Chase gone?
Taub carries on: Derrick was admitted not just with a massive nose bleed but dizziness.
"My best friend is trying to kill himself," House reminds them. "He just wants to die with a little dignity," Adams tells him. But House doesn't think that's possible. "It's a midline granuloma," he says of Derrick, before retreating to his own office to plan his next move.
"Oh, crap, turn off the mic!" Taub and Park are in the monitoring booth while Derrick gets a PET scan to confirm House's diagnosis when Taub realized Derrick can hear them. Except he can't. The mic is off. "Not according to his brain," Taub says, looking at his monitor. "His temporal lobe is completely lit up. The auditory portion. He's hearing something." Derrick is lying still on the scanning bed. "Foreman's trying to date me. I assume it's because you called him." Wilson is confused by House's sudden appearance in his office - and why is he dragging an IV pole? More importantly, why does he feel so dizzy? Before he can deny House's accusation, Wilson begins to put it together: House has drugged his coffee. Wilson slumps over on his desk as House hooks in the IV. "Our patient is hearing voices," Taub tells House. Derrick denies it, but the PET scan tells a different story. "He's at the right age for the onset of schizophrenia," Park notes. They hardly need House for this. Though Derrick's tox screen was clear, House wants them to check his dorm for drugs. Taub and Adams find Derrick's stoner roommate, but he claims Derrick is straight. Adams finds something odd, though: a picture of a young boy hidden in sock drawer. "We need to talk to Derrick about some medical matters." Adams and Taub try to politely usher out Derrick's girlfriend to ask about the picture, but Derrick says that she can stay. He's surprised when they pull out the picture. "It's my brother, Christopher," he says, sadly. He's never mentioned him because he's been dead for almost ten years. Adams gets it: "Is that the voice you hear in your head?"
"So now my hair's going to fall out next week?" Wilson is not amused when he wakes up. "No, all I did was temporarily kill you. How was it?" House asks. House simulated "death" by dosing Wilson with a high-powered anesthetic. "No dreams, no thoughts, you experienced nothing. Now imagine that without the waking up on the couch part. Nothing times infinity." But Wilson doesn't think he proved death is nothing, only that propofol is. House is confused. "You're saying the end is not the end? I was expecting, 'Nothing is better than something lousy,' but not 'The angels are waiting for me.'"
Wilson has no interest in having this conversation with House. "I'm not going to change your mind, and I don't care," Wilson says. "More importantly, you're not going to change mine." He's spent 20 years watching people die. "When I watch that transformation, sorry, I don't believe that we're just a bag of chemicals."
"So, are we going to talk about the patient, or wait for House?" Park asks the team in the outer office, while House is otherwise occupied in his office. She and Adams want to go talk to him, but Taub doesn't think there's anything anyone can do. "Temporal lobe epilepsy. Causes voices, dizziness. Trauma from the seizure would explain the nose bleed," he says of Derrick.
"You know about all of my siblings, and cousins and aunts and uncles . . ." Taub and Adams come to get Derrick for a test and walk in on a fight with his girlfriend about the brother she never knew he had. Derrick says she's overreacting, but when Adams invites her to stay while they perform the test, he says she's leaving. "Derrick, come on. I mean, we should at least talk," she says. "No, I'd rather you just leave. You don't need to come back." "Any odd tastes or smells?" Adams is running Derrick through a battery of potentially seizure-inducing tests, but there's no reaction. She begins to remove the electrodes. "So, you won't admit to your doctors that you're hearing your brother's voice, which is dangerous. And now, you lost your girlfriend over it, which is stupid. I assume there's more to the story?" she asks.
He begins to tell the story of how his father drank himself into oblivion after his brother was killed by a drunk driver, when suddenly Derrick starts rubbing his eye. "Do you need a tissue?" Adams asks, but he says no and continues.
"After Dad left, my mom moved us away," he says. "She got rid of all the pictures of Christopher, and never mentioned him again. It was like he never existed. And that worked for us."Suddenly his eye is bothering him again. "I was seeing spots, but now I can't see at all. Is that from the test?" Nope. She starts pushing and rubbing his eye ball. He can see again, fuzzily at least. She broke up a clot in the artery behind his eye. "Is that bad?" he asks. "I don't know, because I don't know why it happened," she says. "I recently hacked into your old files," House tells Wilson, leading him to a table in the crowded cafeteria. House found the case of a six-year-old boy with bilateral retinoblastoma; while other doctors recommended removing both eyes before the cancer spread, Wilson advocated for a new photon beam radiation. "Saved the kid's vision, probably saved his life," House says.
Wilson remembers: Mikey Kimball, his first case at the hospital. And who should be sitting at the table where House stops, but Mikey, now Michael, who is about to graduate and wants to go to med school. "He's going to be a doctor, instead of being dead," House says.
House told Michael about Wilson's cancer. "There's so much you can do, even in a small amount of time," Michael says. "You saved my life in just a few months." "I wonder . . ." House begins, as he rises to address the cafeteria. "Is there anyone else here who's alive because of Dr. James Wilson?"
Nearly everyone rises. House has gathered them to thank Wilson for saving their lives and giving them time they wouldn't have had otherwise.
House says, "I did the math: 74 children are alive today because of you; 14 grandchildren." Which is a very touching moment, until Wilson does some math of his own. "Mikey Kimball started kindergarten before the age cutoff. He would have graduated high school last year." None of them were really patients of Wilson's. "A glowing recommendation you just wrote for me on my laptop." Taub hands Foreman a prewritten letter. "I notice it's lacking your signature on the bottom." Just as Foreman is chiding Taub for prematurely predicting House's demise, and pointing out that he's actually dealing with his feelings . . . he notices that there appears to be water coming from underneath the door to his bathroom. House. "I didn't do it," House tells him. "Whatever 'it' is. But if I had shoved those season tickets down some toilets, I wold have done it because you asked me to. You wanted to replace Wilson. I prank Wilson all the time. Enjoy."
"I got you three. But I drank them." Wilson beckons Thirteen to his beer-bottle-strewn diner table. "You didn't have to call me," she says. "But I appreciate I made the list." It wasn't entirely unselfish. He didn't feel like he could talk to any of his terminal patients. "But, what is it like? Does it ever stop being surreal?" "It'll stop in about five or six months, give or take, in your case," she answers.
He had a new experience today: one of his patients cried for him. Thirteen says that's the human response: either overly saccharine because it makes them feel good to give sympathy, or they ignore you, because hiding from mortality makes them feel better.
"Why can't they just say something that makes me feel better?" Wilson asks. "Like what, exactly?" Thirteen laughs. But of course there's no answer for that. He tells her about wanting to spend his remaining time not in a chemo suite but with family and friends. "Friends, or friend?" Thirteen asks.
"Hi, this is Greg House. Again. Third message. Hopefully indicating how much I want you to call me back. I'd say that your son is dying to increase the urgency, but you probably already know that." House has advanced his campaign to Wilson's parents now, as he walks the team down the hall to a bathroom.
Meanwhile, some of Derrick's symptoms seem like they might be psychological. "Grief avoidance can lead to all sorts of anxiety disorders, which can manifest into physical illness," Park says, as House downs a handful of Vicodin. House naturally dismisses the idea. "So we're going to avoid grief avoidance?" Adams asks.
Maybe Derrick hurt himself at practice and never told anyone. "Could have set off DIC, would explain everything," Adams says. Why are they standing outside a bathroom? "I didn't say I had to go in," House explains. A janitor soon emerges. "Need some more mops in here!" he yells, revealing flooding as House smiles. "What exactly are you looking for?" Derrick asks Park as she performs a lumbar puncture. She's looking for blood. If his spinal fluid is yellow instead of clear, it means he's had a subarachnoid hemorrhage. And she thinks his mother didn't let him grieve over his brother's death. "There are people here who could help you with that." But before they can continue, she stops the procedure: "The opening pressure's way too high." "The prodigal daughter returns." Thirteen announces herself to House, who's watching patients in the chemotherapy suite. She's talked to Wilson. "Friends respect each other's decisions, even if they don't agree with them. It's called loyalty." House thinks loyalty is just a tool to get people to do things they don't want to do. That doesn't square with Thirteen, though. He fired her so she would be forced to spend the rest of her life doing exactly what she wants. "It was probably the most selfless thing anyone has ever done for me. And you don't even like me that much."
"I surrender. I have been a disloyal, disrespectful jerk. I should have listened to what you wanted." House waves the white flag, literally, in Wilson's office. He wants to have dinner tonight. "No more tricks, no more manipulations." "I came as soon as I got your message. Is he going to be OK?" Derrick's mom arrives, and Adams tells her they hope it's just excess fluid on Derrick's brain from an extreme migraine. Not good, but treatable. Derrick's mom sees the picture of Christopher by Derrick's bed and recoils. "He's been hearing Christopher's voice for the last ten years, and it's possible that repressing all that grief he felt is actually causing some of Derrick's symptoms," Adams tells her.
"I don't even know if this voice in my head is something I invented or if it's what Christopher was really like," Derrick says. "With no photos, no video, my memories . . . I really don't have any anymore. Maybe you could just tell me a little bit about him?" But his mom just excuses herself to get a cup of coffee. "I'm sorry, it was a long drive in." "I know that the tiramisu here is excellent, but I ordered off-menu," House tells Wilson at dinner, while the waiter unveils a plate full of Oreos. It registers immediately with him. "Great. I told you you didn't hang the bear bag high enough." "He was a smart bear," House says. "I'm almost certain he untied my knots." "Well, he wasn't that smart. He left the Oreos behind," Wilson says. "You hiked 32 miles, eating nothing but creamy filling," House notes. "The black stuff is overrated," Wilson says.
House raises a cookie to Wilson: "To climbing the hill." But now it seems like he's having a change of heart. "If I did decide to stick around a little longer - I do feel pretty good. Maybe I should try it for a little while." "I think that's reasonable," House admits, which makes Wilson think the whole dinner was a con. "You drown me in nostalgia so I'll think about our friendship and feel some kind of loyalty and agree to more chemo," he says.
House is adamant it was real nostalgia and a real decision. "I need you, OK? I want you to be around as long as possible. Because I don't know what I'm going to do without you." Wilson cuts him off and gets up to leave. "No! Don't do that. I don't owe you anything. Our entire relationship has been about you. My dying is about me."
House finds him later crying in his car. "You don't want to die," House says. Of course not, but he tried. "One time. You don't have to just accept it."
"Yes! I do have to accept it," Wilson argues. "I have five months to live, and you're making me go through this alone! I'm pissed because I'm dying, and it's not fair. And I need a friend. I need to know that you're there. I need you to tell me that my life was worthwhile. And I need you to tell me that you love me." House is near tears now, too. But he's not giving in. "I won't tell you that unless you fight."
"Blood vessels are non-reactive. It's not a migraine." Park and Adams review Derrick's scans from the monitoring booth. "Hey, I'm not feeling so well. How much longer?" he says from the chamber. They're done, so Park presses a button and the bed slides out from the machine. "Thank you, Dr. Adams."
Before she has time to process his mistake, she notices water dripping from the ceiling. "It looks like the ceiling might . . ." And then it does: it crashes down on top of Adams, Park and Derrick, followed by a deluge of water, shorting out all the equipment and the lights. "What are you doing back here?" Taub asks House, who finds the team after meandering through the wet wreckage of the hospital, now on backup power, with sections cordoned off and full of firemen. Adams is furious, as Taub tends to her wounds. "You think actually showing up for work is enough to make up for ruining an MRI, endangering the patient, injuring us?" He doesn't seem too concerned. "I've got an airtight alibi . . . that I'm working on."
Taub thinks he's back only because something's going on with Wilson, but House says it's all in Wilson's hands now. "Get any good pictures before the MRI drowned?" Park tells him they ruled out a migraine and mentions that Derrick confused her with Adams, which gets House thinking.
"So, what do you think's going to happen when I stick a needle into his ear drum?" House gathers the team in Derrick's room. "He'll scream in pain," Adams argues. "Very small needle, very steady hand," House says, tilting Derrick's head back and inserting the syringe. "Now, when I pull back on the plunger what do you think's going to come out?" Air? Nope, it's blood. "Persistent stapedial artery. Should disappear in the embryonic stage, but just like his dead brother, he really can't let go. It's an artery that's been pressing against the temporal lobe of his brain, right above the ear canal. Explains the voices, the dizziness, everything. And you guys can explain how we're going to make it better."
"You're being an ass," Taub tells House in the hall. "You can't just give up on Wilson. You know he needs you. You know he's making an impossible choice. He just doesn't want to live in pain."
"Life is pain!" House screams. "I wake up every morning, I'm in pain! I go to work in pain! You know how many times I wanted to just give up? How many times I thought about ending it?" "Had to delay the surgery because our patient drank ammonia from the janitor's cart," Park tells House the next day. "I guess he didn't want to live without his brother's voice." House turns and starts furiously walking toward Derrick's room.
"You can't wait to die? Here, let me help you," he says, and he starts wrapping Derrick's breathing tube around his neck and choking him. Park and Derrick's mom try to pull House off as Derrick fights to breathe. "See! You want to live!" It looks like House might really harm Derrick, when Park smacks him with his own cane. "You spent your whole life looking for truth! But sometimes, the truth just sucks," she says.
"I'm going to be leaving quite a bit earlier than we had talked about," Wilson tells Foreman. "Next day or two." Foreman guesses correctly that this change of plans is House-related. "He's not my child. I cannot be responsible for the happiness of Gregory House."
"You are responsible," Foreman says. "The past 20 years, you've had three wives, hundreds of colleagues, thousands of patients. But you've kept that one best friend." "He wants me to suffer the misery that I don't want to go through," Wilson says. "Chemo won't make your life any better, but caring will," Foreman tells him. "Enduring pain to do some good for someone you care about - isn't that what life is?"
At home, House ices his neck where Park beaned him and plays some sad music on the piano. Wilson is home alone, too. He reaches into a cupboard for a bottle of wine and sees a package of Oreos and smiles. "Mom? That picture of Christopher that I had on the stand - did you take it?" Derrick asks his mom. She did, but she didn't throw it out. "If I agree to get the surgery, can you bring that picture back?"
Taub and the team successfully perform the surgery on Derrick.
"Not home!" House yells from his piano bench to whoever is banging on his door. It's Wilson. "I'm ready to start the next round of chemo," he says. House is confused. "Why?" "Because you need me, and I don't think that's a bad thing anymore." "No," House says. "You're the only one I listen to. The last couple of days I didn't, and I almost killed my patient. I think it's time for you to accept that you're just smarter than I am."
"Are you really OK that there's only five months left?" Wilson asks. "No, but it's better than nothing," House says. "Um, how do we start?" Wilson asks. "Well, I'm not going to say I love you," House tells him. "Thank God," Wilson says. "Got any Oreos?"
"The surgery worked," Derrick tells his mom, sadly. He knows because he no longer hears Christopher's voice. She brings out the picture, the one he knows, plus a bunch more she hung on to. "And this is the peak, almost 8,000 feet." Wilson is showing House the mountain he wants to hike. "You do realize that my leg situation has deteriorated since the last time we went hiking?" House asks. "Just add another day," Wilson says. They're interrupted by Foreman and the hospital lawyer. "Are these yours?"
He holds up bits and pieces of the tickets that House used to clog the plumbing, which ruined the MRI machine. They have House's name and fingerprints. "OK, well why don't you tell me how many hours of picking up trash you want me to do," House says. But it won't be that simple. The fire department gave the tickets to the police, who contacted House's parole officer. It's felony vandalism.
"He's going to revoke your parole. There's nothing we can do," Foreman says. The lawyer says House must report to jail on Monday and serve the remainder of his sentence. The dread sets in. "And that's . . . that's how long?" House asks. "Six months," Foreman tells him.