Nolan heads for his car after a long day of sucking at work and life, only to find House on the curb waiting for him. "Not the most exciting use of the overnight pass I've ever seen," he says to the clearly heartbroken guy. "She left and I'm lost," House says. But Nolan has a different way of looking at things: House is hurt because he connected enough with another person to get hurt by her and he dealt with that pain in a productive way by skulking around the parking lot waiting for the psychiatrist to show up. That means, Nolan says, that House is ready to leave Mayfield and return to his life.
Time for another re-birthday! This time, House is leaving. They hope to never see him again, yadda yadda yadda. House blows out his candle, hugs Beasley and, begrudgingly, Alvie (and also, I think, ad-libbed a butt-pinch), and stuffs his face in the cake, just to be fun! It's almost as tough to watch as the rap. Almost.
Finally, House leaves Mayfield. He walks down the long driveway towards the lone bus stop. Alvie watches him go, looking tearful and then inspired. He knocks on the nurse's station window and tells Beasley that he wants to take his meds so he can "get better." Except that the reason why he didn't take them in the first place is because he's not capable of making those kinds of connections and logical thinking. Do the writers really think that people who refuse to take their meds do so because they don't want to get better? Or that they even realize there's something wrong with them that needs medication in the first place? What a slap in the face to people with real mental illnesses.
House gets on the bus, because he apparently doesn't have any post-traumatic stress disorder from the last time he took a bus and horrible, life-ending things happened. House sits in the back, wearing Alvie's smiley face T-shirt under his jacket. "Prepare to succeed!" the sign on the side of the bus says. I'm prepared to see CTB sitting next to House, or an errant garbage truck to slam into them. Something to tell me which show I'm really watching. It doesn't happen, but the previews for the upcoming season make me just a little bit hopeful.