A father is dirt-bike racing with his son Adam on the back. They pull to a stop and the son convinces him to switch places. Then the boy spasms and tights his hand on the throttle, and they go running wild. The father is thrown clear and Adam crashes into some pipes and the bike bursts into flame.
The boy is brought to the clinic with 40% burns on his body and taken immediately to the E.R. Foreman interrupts House to do a differential due to low potassium and House agrees – his diagnosis for Adam isn't hopeful even ignoring the massive burns. Meanwhile Nurse Brenda approaches Dr. Cuddy and needs equipment for a lecture that a Dr. Weber is giving – Cuddy determines House has invited him. She confronts House, who is working on a coma patient who has a migraine – he gave the patient a migraine to test some new medication.
The staff uses a galvanometer to check Adam's heart since there's not enough skin to do an EKG. The parents report he took pot but isn't on any other drugs that they know of. Adam goes into convulsions – House suspects MS but they're unable to give him the standard lumbar or radiation tests of his brain. House suggests a Doppler sound device and they go for it.
Cuddy finds herself introducing Dr. Philip Weber, who deals with headaches. House is lurking in the audience and Wilson confronts him after realizing he and House went to Hopkins and studied under the same teachers. It turns out House was supposed to get an internship until Weber accused him of cheating. Now House plans to prove he's a bad scientist. The staff uses images to check Adam's eye-response patterns, which will show up on the Doppler scan. They get a possible result as well a signs of a bleed, and Foreman breaks in on House, interrupting the lecture. Foreman and Chase try to locate the bleed while House confronts Weber on his supposed breakthrough in India and Weber finally figures out who is confronting him. House disputes Weber's study and Weber asserts House needs a live conscious person to test on. Meanwhile the unconscious Adam has an orgasm in the hyperbaric chamber, and House induces a migraine in himself to test Weber's medicine. Weber's medicine doesn't work.
Foreman administers some medicine to help with House's migraine but clearly he's not operating at capacity. They conclude something has crossed his pain and pleasure receptors, which will help Adam deal with the burn pain but may be signs of infection. Cameron suggests they wait but House proposes they use maggots to eat the dead flesh from the burns. Wilson confronts House on how he inflicted the pain on himself to make up for pushing Stacy away. The staff report the maggots are working on the burns but the brain irregularities are still present. House orders a risky lumbar puncture and Foreman reluctantly advises the parents to approve the test and the mother blames the father.
Foreman goes ahead with the lumbar puncture and manages to pull it off, but the test is negative. They have no other way to test for the telltale lesions so House goes into Adam's room and has the anesthesiologist wake him up. Adam is incredible pain but needs to know if he's feeling tingling – Adam doesn't remember and House knocks him back out. After taking a shower, House begins to hallucinate much to Cameron's consternation.
House meets with the staff, fully recovered but a bit vague on what he took. House concludes that Adam was taking anti-depressants which accounts for the seizure, and the excess serotonin is the result of the medicine. "Serotonin storm" is lethal, but treatable. House wants to speak to Adam again but the parents have forbid it. So House confronts the parents to determine if Adam was suffering from depression. The parents are sure he's told them everything, and House has no choice but to go back to differential diagnosis. He still can't explain the orgasm and goes into Adam's chamber over the parent's wishes.
The parents get Foreman, who intervenes, but House notices a mark on Adam's wrist – a burn. House confronts the parents with the fact Adam has a cigarette burn and nicotine stains. Adam was trying to break his habit and using cheap anti-smoking meds with anti-depressants in them.
Later Cuddy confronts House and wants to know if he took LSD. House (kind of) admits he did to cure the migraine, and then took anti-depressants to short-circuit the hallucinations. Weber barges in and complains House has reported to his corporate sponsors that his drug doesn't work and House acknowledges they're even. And the father wonders if Adam will blame him for the accident. Later, House is at home and has hired a hooker…as a less painful distraction.