House awakens in the Mayfield Psychiatric Hospital after suffering through the painful effects of Vicodin withdrawal. Feeling better, he wants to leave. Dr. Nolan refuses to sign a recommendation to the board of medicine saying he is able to return to work. House resigns to stay at the hospital and get his clearance.
House tells Dr. Beasley that he will do anything to get that recommendation. He even threatens to turn Ward 6 upside down if he has to. House meets his new roommate Alvie, who is hyperactive while off his meds. House then begrudgingly participates in group therapy with Dr. Beasley. House tries to get kicked out by humiliating everyone during a basketball game in the yard, but the doctors won't stand for his antics.
House meets a woman named Lydia who plays piano in the rec room for her sister-in-law, an unresponsive patient on the ward who was a musician. He is intrigued by Lydia.
After House is put in solitary confinement, he comes up with a new strategy to try to get kicked out. He addresses the group in therapy to apologize for his insults, but really goads them into creating havoc on the ward over table tennis.
From the hospital window, House sees Dr. Nolan get into a car with a woman. House convinces Alvie to break into Nolan's office to get the scoop on her. Alvie is unsuccessful, so House comes up with another solution. He pretends to beat up Alvie in the rec room. They are both put on Haldol, but they pocket the pills in their cheeks and give it to another patient in return for the man's phone privileges. House calls Wilson and asks him for help blackmailing Nolan. Wilson refuses, saying that Nolan already contacted him to warn that House may try to do something like this.
A therapist named Dr. Medina makes House undergo a drug test to prove he is taking his meds. Since he is pocketing all his pills, House gets the patient with all the Haldol to submit his urine instead.
House starts to adjust to life inside the institution. His only respite is Lydia's regular visits. They discuss music therapy, and Lydia agrees to bring the cello that her silent sister-in-law used to play.
A new patient named Steve thinks he is a superhero who goes by the moniker "Freedom Master." Median provokes him to break his delusion about his dead wife, but Freedom Master has an episode and is drugged into a catatonic state. House gets angry at Medina over this and turns to Nolan. Dr. Nolan admits that he had switched House to a placebo instead of the Haldol because he knew he was pretending to get better.
House confesses to Alvie that he is out of plans. House waits for Lydia to bring the cello, and he has Freedom Master help her at her car. Lydia willingly gives her car to House for him to kidnap the depressed Freedom Master. House takes him to a carnival where they are lifted in a wind tunnel ride as if they were really flying. Freedom Master is overjoyed, but then really believes he can fly because he's a superhero. He jumps off the roof of a parking garage.
With Freedom Master badly injured, Dr. Nolan wants House to leave the institution because he is a distraction to the group. House earnestly asks for help in getting better. He begins therapy with Nolan and takes his medications, much to the chagrin of Alvie who feels betrayed.
Nolan brings House a suit and has him mingle at the hospital's fundraising party. His assignment is to make connections with strangers. It is painful for House at first, but then he has fun toying with people. Lydia becomes his accomplice. As they laugh about their exploits, she gives House a kiss.
House is eager to discuss the kiss with Nolan. Lydia is married. He also feels guilty about what happened to Freedom Master, and Nolan tells him to apologize personally. During group therapy, Dr. Beasley suggests the patients put on a Ward 6 talent show. House has an idea of how to help Freedom Master, who had been trying to save the silent girl with a music box hidden in the nurse's station. He called it her "voice." House convinces Beasley to allow them to get the music box.
House rebuffs Lydia because someone will get hurt. House is given a day pass and an address. He arrives at a hospital to find Nolan and his dying father. A tearful Nolan asks House to give a consultation. Although House has nothing to add to the diagnosis, he accuses Nolan of having no one else to turn to but his own patient.
House returns to Mayfield to find Lydia upset over her sister-in-law. He apologizes for pushing her away. With both of them in pain, they turn to each other intimately. Yet Lydia stops before it moves forward.
The residents hold a talent show. Although House refuses to participate, he ends up helping Alvie with his rap on stage. House apologizes to Freedom Master, who gives the silent woman the music box. For the first time, she speaks and says thank you. It is a healing moment. Lydia arrives and House takes her in to see the group watching the silent girl play the cello.
Nolan tells House that Lydia is taking her sister-in-law to a rehab facility in Arizona with Lydia's husband. House gets a day pass and goes to see Lydia at her home. He is startled when Lydia's young son answers the door. House wants her but she can't be with him. Later, House talks to Nolan about his feelings. Dr. Nolan is now convinced that House deserves the recommendation to the medical board.
House is discharged. He gets on a bus on his way to Princeton.