Wilson wakes up to the sound of his alarm clock, turns it off, and then goes to see House. He tells his friend that he's not doing anymore chemo and House reminds him that he'll be dead in five months. Wilson doesn't want to extend his life for a few more months in exchange for pain, and House points out that he can alternate treatment periods and gain considerably more time. Despite that, Wilson tells House that he's sorry and starts to walk away. House calls after him that he won't let him die but gets no response.
House arrives at the hospital at the hospital and Foreman greets him, offering him game tickets. However, House points out that the first game is a month after Wilson's anticipated expiration date, and Foreman says that he intended it to show that there are other people who care about him. Upon hearing that, House says that he won't be falling apart anytime soon and leaves... with the tickets.
In the conference room, the team are watching videos of a cheerleading squad. When House arrives, they explain that one of the cheerleaders, Derrick had a massive nosebleed and dizziness in the middle of a rehearsal. House is more concerned about Wilson but the three remaining team members try to focus on Derrick's case. They finally tell House that Wilson wants to die in dignity and that House doesn't have a say in the matter. He tells them that Derrick has a midline granuloma, tells them to run a PET scan, and walks out.
Taub and Park run the PET scan and she suggests that they should get someone else to take the case. He points out that they can't just because someone else is dying, and then notices that Derrick's brain is responding as if he was hearing them, even though he can't.
House goes to see Wilson pulling an IV rack, and Wilson passes out as he realizes that House drugged him. His friend the puts the IV needle in and starts administering chemo. The team comes in and House tells them that he doesn't want to discuss Derrick's case. However, they tell him that Derrick is hearing voice even though he denies it, and that he's at the right age for schizophrenia. They've ordered a psych evaluation and confirmed that his tox screen is clean, and House tells them to check his dorm room.
Taub and Adams go to the dorm room and find Derrick's roommate Floyd smoking pot. He tells them that Derrick doesn't party while Adams finds a picture of a young boy hidden in Derrick's sock drawer. They go back to the hospital and find Derrick with his girlfriend, Courtney. Derrick finally admits that the photo is of his brother, Christopher, who had been dead ten years. Courtney is surprised since Derrick never told him about Christopher, and Adams asks if Derrick hears Christopher's voice in his head.
Wilson wakes up on the couch and finds House at his desk. House points out that he experienced nothing, and that will be what he's experiencing when he's dead. When Wilson objects, House realizes that he believes he's going to Heaven. House says that there's no Heaven or Hell, but Wilson refuses to discuss it. As House leaves, Wilson tells him that he has spent twenty years watching people die, and he's seen the transformation that takes place.
Back in the conference room, the team waits while House sulks in his office. Park wants to bring House in on it and Adams agrees, but Taub warns that House has never listened to them about anything they've ever tried to discuss about his personal life. He tells them that sometimes there's nothing anyone can do and then diagnoses temporal lobe epilepsy and walks out.
When Taub and Adams go to see Derrick, they find Courtney complaining about how he doesn't trust her. When they take him to his tests, Derrick tells Courtney to leave and not come back. She storms out and the doctors take him to a light lab to test for epilepsy. He doesn't display any symptoms and Adams points out that he's in denial over the voices. Derrick explains that he was raised not to talk about it, and Adams describes how House is pretending there is no pain because he thinks everything can be fixed. The patient then explains that his father tried to deal with it but turned to alcohol after Christopher was run over by a drunk driver. Derrick's right eyes tears up but he then says that after his father left, his mother moved them away and got rid of all of the pictures of Christopher, treating him like he never existed. He then tells Adams that he is blind in his right eye and she pushes at his right eye. Once he recovers his vision, Adams explains that there was a clot in the artery behind his right eye and she broke it up, but she doesn't know what caused it.
At the crowded cafeteria, Wilson is getting lunch when House catches up to him and reminds him of a patient, Mikey Kimble, who was six years old and had cancer of the eyes. Wilson advocated for an experimental treatment and saved the boy's vision and his life. Mikey is at their table and tells Wilson that he's doing fine and is going into med school. House reminds Wilson that Mikey would be dead if not for him, and Mikey says that he came because House told him about Wilson's cancer. When Wilson hesitates, House asks if anybody else is alive because of Wilson. All of the customers stand up and tell him what their lives are like since he saved them. They all thank him and applaud, and House tells Wilson that 74 children and 14 grandchildren are alive because of him. However, Wilson realizes that House set the whole thing up and walks out.
Taub goes to see Foreman and has a letter of recommendation for him to sign. He figures that House will implode sooner or later, but Foreman insists that he's fine. At that point, the office's bathroom toilet overflows. Foreman goes to find House and tells him that he knows he's responsible. House tells him that he isn't, but if he was then he pranks Wilson all the time and Foreman wants to replace Wilson.
Wilson goes to a diner to drink after inviting Thirteen there. He explains that he wanted to talk to someone in the same situation and didn't want to talk to one of his patients. Wilson asks if it ever stops being surreal, and she tells him that it will when he dies. He tells her that one of his patients started crying for him, and Thirteen explains that most people either become sentimental or ignore it. When Wilson wonders why they don't say something to make him feel better, she points out that there isn't anything to say. Thirteen suggests that he start treatment and see how it goes, but Wilson says that he doesn't want to spend his remaining time in chemo and wants to enjoy himself with his family and friends. At that, she asks if he means friends or friend.
House is busy trying to get hold of Wilson's father and heading for the bathroom while the team try to discuss the case. Adams suggests that Derrick is trying to avoid grief and the stress is causing his symptoms, and Park agrees. House figures that all of Derrick's symptoms are real and Taub agrees, and Adams suggests that Derrick might have suffered an injury during practice and didn't tell anyone. They arrive at the bathroom and House smile as the janitors try to deal with the overflowing sinks.
Later, Park checks Derrick's spinal fluid to see if he has a subarachnoid hemorrhage. She asks what Christopher says to him and suggests that he hears his brother's voice for a reason Park figures that he's coping with his grief and suggests he see a therapist, but Derrick ignores her. She does the LP and realizes that the opening pressure is way too high.
House waits outside of the chemotherapy suite and watches the patients in treatment. Thirteen comes in and tells him that she talked to Wilson, and tells House he should respect Wilson's wishes. He insists that loyalty is just a tool, but Thirteen points out that he fired her so she could do what she wanted to do. She points out it's the most selfless thing anyone has done for her, and House stares at her in realization.
Wilson is in his office when House comes in, waving a white flag. He admits that he's been a jerk that should have listened to him, and he's made dinner reservations that night. House promises that he's not up to anything and Wilson agrees.
Derrick's mother Jen comes to see Derrick and notices the photo of Christopher on his table. Adams explains that Derrick has been hearing his brothers' voice and that his repressed grief may be causing his symptoms. Derrick says that he doesn't know if what he's hearing even sounds like his brother, and asks Jen if she can tell him anything about Christopher. Jen begs off, saying it's been a long drive, and goes to get some coffee.
House and Wilson enjoy dinner, talk about old times, and order Oreos for dessert because of a camping trip where they had to subsist on them. Wilson finally suggests that he might want to try the chemo and stick around a little longer, and House says that it's reasonable. His friend wonders if House is conning him by using nostalgia. House denies it, but admits that he needs Wilson to stay around as long as possible. Wilson angrily says that everything in his life has been about him and that his dying is about him. He goes out to the car, crying, and House gets in a minute later. He points out that Wilson doesn't want to die and Wilson agrees, but says that he's fought and now he's done. He yells at House, telling him that he's making him go through it alone and he needs to know that House is there for him. House tells him that he won't unless he fights and walks away.
Adams and Park are running a MRI scan as Derrick complains about migraines. Once they're done, they go to check on him and he mistakes Park for Adams. They notice that the ceiling is dripping. It suddenly collapses, dumping water and debris on them.
The firemen clean up later as House arrives and surveys the debris. He tells the team that they have a case and he's done with Wilson, but Taub doesn't believe it. House tells him that Wilson's fate is in his own hands and seizes on the fact that Derrick mistook Park for Adams. He then takes a needle and goes to see Derrick, and thrusts a needle into his eardrum. He then pulls back and shows them blood. House explains that Derrick has a persistent stapedial artery, pressing against the temporal lobe above the ear canal and causing all of his symptoms. As House walks away, Derrick asks if his brother's voice will go away.
Taub goes after House and tells him that Wilson needs him, and he's just trying to avoid pain. House screams at Taub that he lives with pain every day and has never given up. As everyone stares, House walks away.
The next morning, House comes into work and Park tells him that Derrick drank ammonia from the janitor's cart because he didn't want to live without his brother's voice. House goes to Derrick's room and starts choking. He insists that humans want to live and keeps choking him until Park knocks him over the head with his cane and tells him that sometimes life just sucks.
Wilson goes to see Foreman and tells him that he's leaving earlier than they discussed. Foreman wonders if it has to do with House, and Wilson says that he can't be responsible for House's happiness. As Wilson leaves, Foreman tells him that he is responsible for the one best friend that he's kept. When Wilson points out that House wants him to suffer a misery he doesn't want to go through, Foreman tells him that enduring pain for someone else is what life is.
House is at home holding an ice pack to his head and contemplating a bottle of Vicodin. He then goes to the piano and plays.
Wilson is at home alone, eating. As he goes to get a bottle of wine, he sees a box of Oreos in the cupboard.
Derrick asks Jen if she took the photo of Christopher. She admits that she threw it out, and Derrick asks if she'll get the picture back if he agrees to the surgery. Jen agrees and they operate on the stapedial artery.
Wilson comes to see House and tells him that he's starting the next round of chemo. When House wonders why, Wilson says that House needs him and he doesn't think it's a bad thing anymore. House tells him no and admits that he has been ignoring Wilson for the last few days and almost killed his patient. He says that it's time to admit that Wilson is smarter than he is, and admits that he's not okay with only having five months. However, he admits that it's better than nothing and Wilson comes in for Oreos.
When Derrick wakes up from the surgery, he tells his mother that it worked and he can't hear Christopher's voice. Jen hands him his photo of Christopher... and the other photos that she kept.
Later, Wilson plans a hiking trip with House. Foreman comes in and introduces Matt Johnson, the hospital lawyer. He has all of the tickets that Foreman gave him that House flushed down the toilets, and informs him that they've contacted his parole officer. He's been charged with felony vandalism and will be going back to prison to serve out the rest of his sentence... six months.