Down the in yard, Alvie suspects that House is doing way too much thinking, which means trouble for everyone. He urges House to distance himself from his hatred of Medina and what he did to Freedom Master. House says that in his effort to "pretend" to cooperate with the mental hospital staff, he sat back and let Medina do what he did to Freedom Master. Basically, pretending to cooperate had the same effect as actually cooperating. Alvie tells him to forget about this because in a few days, he'll be released and able to go back to his job and his life. With that, they're called inside to watch the "closing ceremonies" as one of their wardmates is released.
The stores don't sell party napkins that say Happy Mental Hospital Release Day! on them, so they have to make do with Happy Birthday napkins instead and call this a "re-birthday." And just who gets to go home today? Suicide Susan! The patients and the staff applaud and say, in unison, that they never want to see her again. Way to make her feel like a failure if she does, in fact, have to come back there. Mayfield is the worst. While they're cutting the cake, House looks around for Freedom Master, but he is not present. "He isn't able to take part," Medina says. This simply will not do for House, who believes that everyone has a right to cake.
House enters Freedom Master's room to find him on the bed, non-responsive. "Leave him alone," Medina says, coming up behind him. House asks if Medina drugged him. Medina says no, and House notes that Freedom Master is "practically catatonic." "He's fine," Medina says, sounding somewhat worried. Alvie appears in the doorway and encourages House to return to the common room for delicious cake and not get himself in trouble. The rest of the patients start to gather in the hall as House snaps at Medina that he took a functioning yet delusional adult and turned him into another Gabby. "Dr. House, let's talk," Nolan says, suddenly appearing in the doorway.
House is still angry when he gets to Nolan's office, saying that Medina screwed Freedom Master up and he's allowed to be angry about it. He's also angry about the fact that he's two levels above Susan and they have the same depression scale score but she gets to go home and he doesn't. Maybe because she tried to commit suicide and you couldn't tell fantasy from reality? These are very different cases, I'd think. House snaps that he's perfectly capable of dealing with his "deeper issues" on an outpatient basis. Yeah, but he won't, even though he tries to bargain with Nolan for three hours of therapy a week in exchange for his freedom. "No," Nolan simply says. Frustrated, House tries to prove to Nolan just how well he's been coping with his problems by showing him that he hasn't been taking his meds and look how well he's doing. That was stupid, House. But he says that the fact that he was able to fool everyone into thinking he was taking his meds shows how high-functioning he is. Great. He was also functioning well enough to diagnose patients while having hallucinations, although we are apparently not going to talk about that anymore. Because it doesn't make any sense that House would know last season that his problems extended beyond the Vicodin and admit that he needed help and admit himself to Mayfield but then decide now that he's totally fine.