Wilson gets up out of bed and goes to see House, and tells him that he won’t do chemo. When House points out that it he’ll be dead in five months without it, Wilson insists that he doesn’t want to extend his life no matter how much suffering it involves. He walks away and ignores House when he yells that he won’t let his friend die.
When House arrives at the hospital, Foreman offers him some game tickets and says that the two of them can go together as part of his new management approach. House points out that the first game is a month after Wilson’s five months is up. Foreman says that he just wanted to show House that there are people other than Wilson who care about him, and House assures him that he ‘ll survive once Wilson dies.
The team is watching a video of their newest patient, Derrick, who is a college cheerleader. They tell House that Derrick was brought in with dizziness and a massive nosebleed. House isn’t interested and continues talking about how Wilson is going to die. Adams finally tells him that Wilson wants to die with dignity and there’s nothing House can do about it. Disgusted, House tells them that Derrick has a midline granuloma, orders them to run a PET scan to confirm, and leaves.
As Taub and Park run the PET scan, she thinks that someone else should take the case since they’re dealing with House and House is dealing with Wilson. Taub refuses, pointing out that they can’t drop a case someone dies. When Derrick’s temporal lobe lights up on the scan, Taub assumes that Derrick has heard them but confirms that the microphone is shut off. According to the scan, Derrick is hearing something, even though there’s nothing in the chamber to hear.
House drugs Wilson’s coffee and then goes into his office as he passes out. He gives him a sedative via an IV drip and then settles down to read a magazine. The team comes in and tells him that Derrick is hearing voices, even though he says he isn’t. Park suggests that he’s the right age for schizophrenia, they’re running a psych eval, and the toxic screen is clean. House tells them to check Derrick’s dorm room and goes back to waiting for Wilson to wake up.
At the dorm room, Taub and Adams discover that Derrick’s roommate is a stoner. He tells them that Derrick doesn’t party, and Adams finds a photo of a young boy in Derrick’s dresser. They take it to show Derrick, who is receiving a visit from his girlfriend Courtney. Derrick finally tells them that he had a younger brother, Christopher, who died ten years ago. Courtney is surprised since Derrick never mentioned it, and he dismisses it as no big deal. Adams asks him if he’s hearing Christopher’s voice in his head.
When Wilson wakes up, House tells him that he’s just had a taste of the nothingness waiting for him when he dies. Wilson doesn’t believe it and House realizes that his friend believes in Heaven. He angrily insists that there is no such thing, but Wilson refuses to discuss it, knowing he’ll never convince House otherwise. He tells House that he’s spent twenty years watching his patients die, and he’s seen what they see when they pass on.
The team returns to the conference room but House refuses to leave his office. Park suggests they bring him out and get him interested in his case. Adam starts to go with her but Taub warns against it, pointing out that House isn’t interested in their thoughts on his personal life. He tells them that sometimes there’s nothing anyone can do and then proposes temporal lobe epilepsy as a differential.
When Adams and Taub arrive back at Derrick’s room, they find him fighting with Courtney over the secret of his dead brother. Derrick finally tells Courtney to get out and not come back. The doctors take him to the light lab for testing and he doesn’t respond to the flashing lights. As Adams removes the leads, Derrick explains that after his brother was killed by a drunk driver, his father turned to drink and eventually left. He winces briefly as his right eye pains him and then tells Adams that after his father left, his mother Jen moved the family away and treated Christopher like he never existed, destroying all of his photos. Derrick then tells Adams that he’s suddenly gone blind in his right eye. Adams manages to break the clotted artery behind the eyeball but admits that they don’t know what caused it.
At the crowded cafeteria, Wilson tries to find a seat without success. House comes over and says that he has a table even though none of them are empty. As he leads him across the room, House mentions Mikey Kimble, a six-year-old boy that Wilson saved years ago. Mikey is seated at the table and thanks Wilson for saving his eyesight and probably his life. He says that he’s going to Princeton now and hopes to become a doctor, and he owes it all to Wilson. House points out that Mikey would be dead if Wilson were, and then asks if anyone else in the room has had their life saved by Wilson. All of the patrons step forward and thanks Wilson for saving them, applauding him. However, he realizes that Mikey is a year beyond the cutoff date and figures that House set the whole thing up. He walks away while House points out that it’s a good thing that all the people Wilson saved are too busy to come.
Taub asks Foreman for a letter of resignation, figuring that House will implode over Wilson’s impending death. Foreman insists that House is fine... just as his toilet overflows. He goes after House, who denies stuffing sporting tickets into the toilets. However, he says that if he had, Foreman should get used to it if he wants to be House’s friend since he pranked Wilson all the time.
Wilson calls in Thirteen and meets her at a diner. He asks for advice on what to do when one is dying and turned to her as someone who was going through the same thing. She advises him that it never gets any better or less surreal, and that people either cry or ignore a terminal patient because there’s nothing else they can say. Thirteen suggests that Wilson try an alternating chemo regime, just like House did, but Wilson says that he’d rather enjoy his time with family and friends rather than suffer. At that, Thirteen ask if he means friends or friend.
At the hospital, House tries to call Wilson’s parents without success and heads for the bathroom. His team trails along after him and Adams suggests that Derrick is trying to avoid facing the grief of losing Christopher, and his grief accounts for his symptoms. Park agrees but House and Taub don’t, and Adams then suggest that Derrick was injured in practice and didn’t tell anyone. House agree and then watches as the janitors try to unplug the sinks in the hospital bathrooms.
Later, Park checks Derrick’s spinal fluid for signs of a subarachnoid hemorrhage. As she performs the LP, she asks what Christopher says to him and Derrick admits that it’s not like his dead brother sends clear reasons. Park suggests that he see a therapist, but Derrick refuses. As she performs the LP, Park realizes that the opening pressure is too high.
Thirteen comes to see House as he watches the chemotherapy patients and tells him that he should respect Wilson’s wishes as a loyal friend. House dismisses loyalty as a tool to get people to do what someone wants. However, Thirteen points out that he fired her so that she could do what she really wanted, and that it was the most selfless thing anyone ever did her for her.
House goes to see Wilson, waving a white flag, and tells his friend that he surrenders. He admits that he’s been a jerk and invites Wilson to dinner--nothing more, nothing less. Wilson figures that it’s another con but House promises that it isn’t and Wilson accepts his invitation.
Derrick’s mother Jen come to see her son and sees the photo of Christopher. Adams tells her what Derrick has been suffering and suggest that the grief repression is causing his illness. Derrick tells them that he doesn’t even know if the voice he’s hearing is Christopher’s because he can’t remember what his brother sounds like. He asks his mother if she can tell him anything about his brother, but Jen quickly leaves, saying she needs to get some coffee after the long trip.
Wilson and House enjoy a quiet dinner together, talking about old times like when Wilson had to hike out with nothing but a bag of Oreos to eat. House has ordered Oreos for desert and Wilson, touched, suggests that he might try the chemo after all. House says that it’s reasonable, but Wilson immediately thinks that House is conning him again, using nostalgia to get him to give in. While House doesn’t admit it, he does admit that he needs House to stay around for him. Angry, Wilson tells House that his dying is about himself, not House, and goes out to his car. As he sits there, crying, House gets in and Wilson tells him that he doesn’t want to die, but he’s done the best he can and he refuses to fight any more. He tells House that he needs him just to be there for him and tell him that he loves him. House refuses, saying he won’t do it until Wilson agrees to fight, and walks away.
As Adams and Park run a MRI to determine the source of the spinal pressure, Derrick mistakes Park for Adams. As the get him out of the scanning chamber, the ceiling above them suddenly cracks open and water and debris drop on them.
Later, House arrives at the hospital as the fireman cleans up the debris. He finds the room in ER getting their minor injuries treated and tells them that he’s done with Wilson. Taub doesn’t believe it but House says that what Wilson does is up to Wilson now. When Park mentions how Derrick mistook her for Adams, House grabs a syringe and goes to Derrick’s room. He jabs the syringe into the eardrum and then pulls out blood when there should only be air, and tells the team that Derrick has a persistent stapedial artery. It pressed against the temporal lobe above the ear canal, causing all of the symptoms. Satisfied that he’s solved the case, House walks away and Derricks asks the others if Christopher’s voice will go away now.
Taub goes after House and tells him that he’s being an ass for abandoning Wilson. Angry, House rounds on him and yells that he lives with pain every day of his life, and that he’s never given up. He then glances at the people looking at him and then walks away.
The next morning, Park greets House as he arrives and tells him that Derrick tries to kill himself because he didn’t want to live without Christopher’s voice. Angry, House goes to Derrick’s room and starts strangling him, insisting that when Derrick is fighting back it proves that it’s a human responsibility to stay alive. When she’s unable to pull House off, Park knocks him in the head with his cane and tells him that sometimes the truth just sucks.
Wilson informs Foreman that he’s quitting early, and Foreman wonders if he’s leaving because of House. The oncologist tells him that he can’t be responsible for House’s happiness, and Foreman points out that through all of the patients and wives that he’s lost, Wilson has been responsible for just one person: the best friend that he’s kept all those years. When Wilson says that House wants him to suffer in misery just to be there for him, Foreman tells him that suffering pain for someone else is what life is about.
That night, House is at home playing the piano.
Wilson is eating alone at home. As he gets some wine from the cupboard, he sees a package of Oreos.
Derrick asks his mother if she took his photo of Christopher. When she admits that she did, Derrick tells her that he’ll agree to the surgery if she gets it back. Jen agrees and Derrick is taken in for surgery.
Wilson comes to see House at his apartment and tells him that he’s going to do the chemo after all because House needs him and that isn’t a bad thing anymore. House tells him no and admits that he’s been ignoring what Wilson wanted and almost killed Derrick as a result. He admits that Wilson is smarter and that he’s not okay with five months... but it’s better than nothing.
When Derricks wakes up after the surgery, he tells his mother that he can’t hear Christopher’s voice anymore. Jen hands him his photo of Christopher... and then all of the other photos that she kept of her younger son. Together they look at them.
Later, House and Wilson are in Wilson’s office planning a hiking trip. Foreman comes in with the hospital lawyer, Matt Johnson. Johnson has all of the tickets that House stuffed down the sewage system, jamming the pipes and flooding the MRI. Foreman says that he tried to handle it internally, but the firemen found the tickets and turned them over to the police, and they confirmed that House’s fingerprints were on them. They’re charging House with felony vandalism and revoking his parole, meaning that he will go back to prison and serve his remaining six months there.