A man, Lee, wakes up in a hospital in Middletown, NY, but nobody is able to hear him and he's unable to move. Dr. Kurtz is preparing Lee for organ transplant because they believe he's brain-dead. However, House is there after a motorcycle accident and insists that Lee is still alive but suffering from locked in syndrome. Kurtz disagrees with him but House gets Lee to blink to acknowledge he's conscious.
Kurtz confirms that Lee is conscious and his brain is fully functional. Lee remembers that he was riding his bike when the brake malfunctioned and he had an accident, and his brain stem is cut off from the rest of his body. Lee wonders where his wife Molly is. House wonders if the brain damage caused the crash rather than the other way around. Kurtz disagrees with House's diagnosis and orders him back to bed. Molly comes in to see Lee and he doesn't want his children to see him like that.
House calls in his team to analyze Lee and they run a differential. Thirteen wonders why he was in Middletown and House says he was buying a rare guitar. House has some forms on hand and gets Lee into the hospital's MRI. They put a pair of MRI virtual goggles on him that make it appear he's on a beach… talking to House. Lee has a hallucinatory conversation about God and he thinks House was sent there by God. Lee's children are playing on the beach.
House checks in with Lee later and says he has a lesion in the central pons of the brain, a lesion House believes is caused by cancer. House notes that if Lee gets sicker because of Kurtz' antiviral treatment, it'll prove Kurtz wrong. House is intrigued by Lee's case and as they talk, Lee has a seizure. Kurtz still disagrees with House but Lee signals by blinking that he wants House to handle his case.
Taub and Cuddy meet House as he arrives with Lee, and Cuddy wants to know why House was in New York. Taub tries to take his job back but House doesn't believe he's committed. Wilson arrives and also wants to know why House was in Middletown. House again claims he was buying a guitar but Wilson doesn't believe him, and suspects House is going to another state to get drugs. House responds by claiming he was telling one of Wilson's ex-wifes that he's making more money on the lecture circuit so she should adjust the alimony.
Kutner and Taub check on Lee and Taub admits he isn't sure if he cares enough to try and impress House. They notice something and go to get House. They suspect his condition was brought on by alcohol but Lee doesn't drink heavily. Later, Thirteen puts in a catheter and prepares him for surgery so they can perform a brain biopsy to check the lesion. Lee's wife and children arrive and tell him they love him. Molly gets them out as Lee cries.
Chase performs the surgery and puts Lee under. Lee hallucinates himself back on the beach playing with his children as House looks on. Lee still insists that God brought House to him to cure him. Lee wakes up after the operation as Chase checks his brain function with yes-no questions but Lee discovers he can no longer blink.
House and Foreman conclude that the surgery may have caused swelling and damaged the nerves. The team goes back to differential and eliminates symptoms, and Taub suggests that they hook Lee up to a brain-computer interface. Taub waits for Lee to move the cursor on a screen with brain impulses, but gets no response.
Wilson pursues the matter of House's visit to New York after learning his ex-wife in New York was out of the country. House reveals he was going to see Foreman's brother, who is in prison.
Taub talks to Lee about how he's sick and scared of his career. As he gets up to leave, the cursor moves and Lee recovers consciousness. They ask him about contributing factors and Molly notes he was in St. Louis. Lee denies it and House tries to determine where he was. He figures that Lee was having an affair but Lee knows that he wasn't. He has no way to communicate that, however.
Using yes-and-no questions and working with Molly, House determines that Lee was living near his home and stayed with a friend. Kutner and Taub check the house's basement where Lee was staying. What Lee can't tell them was that he was staying there when his business wasn't doing well, and he didn't want to scare his family. Kutner determines Lee worked as a temp at a factory making rechargeable cell phone batteries. They suspect heavy metal poisoning from cadmium and go back to the hospital to use chelation to scrub the particles out of his body. As Taub tends to Lee, he thanks the patient for proving his brain-interface idea was correct. Later, Foreman talks to Lee about buying jewelry for Thirteen, but she didn't wear it. Lee remembers she wore it the other day when she inserted the catheter. When Molly sits with him, she wonders why Lee didn't tell her what was going on.
Taub goes to see House and insists he wants to keep his job. House says he needs to come up with a good idea, and Taub insists the brain interface was his idea. House points out the credit goes to the guy who made the machine and wonders why Taub is there. Taub admits that what they do there terrifies him, but he has to overcome it to matter. House points out Taub hasn't done anything on his own to improve Lee's condition and suggests that maybe he doesn't matter.
Thirteen starts to close Lee's eyes so he can sleep but notices the epithelium is torn. She puts dye into his right eye and determines it's ulcerative keratitis, not cadmium poisoning.
Cameron tends to House's injury while House discusses the case. She suggests he do a LP to narrow it down, and he wonders why he fired her. Later, Wilson checks and confirms that House didn't visit Foreman's brother. He again asks House what he was doing in Middletown, and House says he went there to check on the caregiver Wilson was sleeping with, the same caregiver who takes care of Wilson's brother.
Foreman does a lumbar puncture but Lee flatlines. He hallucinates himself on the beach with House again, who informs him he's about to be dead. They revive him while Lee admits to himself that he can't do anything for his family. Kutner interprets his beeps through the brain-interface that he has an itch in his right foot, indicating liver problems. As they prepare to test his liver, Kutner asks where Thirteen's bracelet is. She explains that she wore it earlier when Foreman didn't notice, but she got some urine on it when she put the catheter into Lee. Kutner finds a rash on her arm and concludes that there were rats in the basement where Lee was staying, and he got a leptospirosis infection transferred via urine spread through a cut on Lee's finger. They start treatment and Kutner gets Lee to concentrate and move one finger.
House congratulates the team on coming up with the rat diagnosis and Taub takes credit for it. Once he leaves, House wonders if Kutner is okay with the fact Taub stole the credit from him. House figures that if Taub cares enough to lie, he's good enough for the job. As House goes, Wilson hands him a cell phone and says he stole it. Wilson figures that House wouldn't have lied initially if he found out Wilson was dating a caregiver. He called the last numbers on House's phone and learned he was calling a psychiatrist.
House goes into Lee's room and retrieves the cell phone he placed there to listen in on his team. Lee wakes up and says that God must have sent House to cure him, but House says he's much less interesting now. As they go, Wilson wonders what has changed with House that he'd see a psychiatrist, and figures Cuddy is the reason. House says he isn't going back and erases the phone number, and says the therapy didn't work. Wilson warns he'll end up alone, but House just leaves.