A nurses' strike sent the Princeton-Plainsboro emergency room into chaos as "House" returned for its first new episode since the end of the -- oh, I get it -- TV writers' strike.
The case du jour centered around a man who caught House's attention in the ER because he was just too darn nice. House knew something must be wrong with the man. There was. More on that later. After some initial introductions and some particularly distracting camera work that had the characters talking directly into the camera as the audience experienced the point of view of the character that character was speaking to. (Told you it was distracting ... and confusing). After meeting the too-nice guy, House wondered if he was Canadian. He wasn't. He was sick, so it was time to figure out why.
The team debated over whether the patient's niceness was actually a symptom. This started some discussion about whether everyone is on a bell curve of niceness where most people fall somewhere in the middle, but the extremes on either end would be House and this guy who's too nice. House thought the niceness was a symptom.
While bowling with Chase -- that's right, Chase -- House talked about how he felt like he was losing touch with his best friend Wilson since Wilson started dating Amber. Chase's wisdom gave House the idea to propose "joint custody" of Wilson to Amber. They decided it was a reasonable suggestion, although Wilson stayed out of the discussion because he's afraid of both of them. They turned to Cuddy for the final word on the arrangement, but she wouldn't offer her judgment until House promised to complete performance reviews for the doctors on his team.
Back to the patient, House decided the man had Williams Syndrome, which meant he was missing the genes that make him suspicious. That only addressed the niceness that House was concerned about, but the other symptoms didn't fit. And, since this was just 13 minutes into the episode, it couldn't have been the final diagnosis. Cue: the patient having a seizure.
House decided the team should test the man for neuro-syphilis, and that opened an ginormous can of worms. The patient said it was a waste of time because he didn't have syphilis and he didn't believe his wife would cheat on him. His syphilis test came back positive and it made the man's wife wonder if he's really as nice as he seems or if she's been in love with a symptom for years. This led Kutner to believe in his bell curve idea and gave him the idea to test House's blood for syphilis, thinking it could be impacting his behavior, just in the opposite way.
When Foreman became outraged that House was avoiding giving the doctors their performance reviews, he volunteered to do them, which was exactly what House wanted. But when he tried to give Thirteen a performance review, she cut him off and walked out of the office. Taub later had a similar reaction and told Foreman that House was tricking him into thinking he had authority as a way to prove he has none. Taub said House knew the doctors would stand up to Foreman and let him know he wasn't superior, which would put him in his place. House essentially admitted that he set up Foreman so that the rest of the team would see him as an equal.
On his play date with Wilson, House tried to get his buddy drunk in order to prompt him to get into a fight with Amber later that night. Wilson didn't like that and went home. Amber wasn't happy that House returned Wilson to her drunk and insisted on a penalty. They agreed to come up with penalties later.
Kutner's test for syphilis on House's blood came back positive, and the team wondered whether the diagnosis and treatment would alter House's behavior and temper his medical prowess. They got together and told House, but he said nothing. They gave him medicine for it. They then sat around with Chase and Cameron to discuss it all and wondered whether the syphilis made House who he is, and Chase asked Cameron if she'd slept with House. She didn't answer, saying it's none of the other doctors' business, and none of Chase's business. She never did answer and kept defending House.
As the team treated the patient with drugs his behavior changed and he went from being too nice to being overly mean, then had a heart attack. The team discussed the new development until House put Foreman on the spot and agreed with Foreman's suggestion. The team wondered if House was already changing because they were treating his syphilis. But he told Wilson that he made it all up and planted a blood sample that he knew they would test. Wilson, of course, told Amber and she told Kutner and Taub.
Knowing that House didn't have syphilis, Kutner surmised that the patient also didn't have syphilis. He figured out that the man had a Costa Rican parasite that presented a positive test for syphilis. House was impressed. The parasite was treatable and the man appeared to get better, actually admitting a dislike for ketchup.
With the case figured out, House handed Cuddy a stack of performance reviews but they were all the same -- except for one. It was for her. House slammed Cuddy's ability as a doctor and got personal. "What you want, you run away from. What you need, you don't have a clue. What you've accomplished makes you proud. But you're still miserable." He asked her to sign it. Cuddy told House that both he and Amber are "losing fingers" for breaching their custody contract over Wilson. They were made to change a patient's hospital bed sheets. Wilson watched from afar and smiled.