He enters the dialysis room and says "you're stupid." Chase and Hadley wait to see which one of them he's talking to, but it's actually the patient this time. James, House says, is addicted to cough medicine because it makes him stupid. Dara scoffs at this, but House explains: "he's smart compared to you. He's a moron compared to what he was." James was sick of being a super-genius, so he took IQ-lowering cough medicine with a shot of alcohol to prevent brain damage. Not sure how that works, but okay. House wraps it up: they thought he was abusing the alcohol and using the cough medicine for medicinal purposes, but he was actually abusing the cough medicine and using the alcohol for medicinal purposes. James doesn't deny it, so even stupid Dara realizes that House speaks the truth. She asks James why he deliberately made himself less intelligent. James says he was "turning down" his geniusness because he was happier that way and "life was bearable." "I thought that I did that," Dara says, because now is the time to feel sorry for yourself. Come on, Dara. "You do," James says. House has had enough of this nonsense and says long-term cough medicine abuse explains all of James' symptoms. Removing all traces of it from his system should make him healthy again. And miserable. "I don't think I can live without it," James says. "You'd be surprised what you can live without," House says, probably knowing some of James' pain. And not caring.
After the break, James is cough medicine-free, feeling better, and sketching a toroidal helicon plasma device, because he's a genius again and that's what geniuses do. Dara tries to be interested and he tries to explain it to her, but there is clearly a disconnect so James sends her away to get him some juice. He immediately turns to Foreman and says the difference between his IQ and Dara's is now greater than that of Dara's and a gibbon's. "Having sex with her would be an act of bestiality," James says. So he's unhappy and an asshole as a genius? But at least he knows it, saying he's a jerk but he owes her "everything" and wants to want her -- but without the cough medicine to stupidify him, he can't. You're telling me that geniuses can't be happy unless they're with other geniuses? What about Marilyn vos Savant? She has the highest IQ in the world (as she's so fond of telling us) and she isn't married to a super-genius man. Of course, it is her third marriage and it's the guy who invented the artificial heart and she uses her world-record intelligence to solve word puzzles submitted by Parade magazine readers and maintain the most boring Twitter account ever, but still. There's hope for you yet, James!