So House and the Cottages are back where they started from: a bunch of symptoms with no apparent cause. House leaves the room to "take a leak," which the Cottages should know by now means he's up to no good. Adam's parents find House scrubbing up to enter Adam's sterile room, and run to get Foreman, who enters the room without putting on all his sterile clothes to stop House from waking Adam up. "No pain, no gain!" House sing-songs as he prepares to inject Adam with wake-up juice. Foreman grabs House's arm as House grabs Adam's, and that's when House notices a small, circular burn mark on Adam's wrist. Foreman doesn't think it's very significant, but House does.
Out in the hall, House asks the parents if Adam smokes. "I'd kill him!" says the guy who's perfectly cool with letting his son smoke weed, cheat on math tests, get drunk at parties, have sex, and drive ATVs. House is pleased to report that Adam was, in fact, keeping one secret from his parents; he's a smoker. He has a cigarette burn on his wrist and a nicotine stain between two fingers. I can understand where that nicotine stain came from, but how do you burn yourself on the wrist like that by accident? Maybe he did it while stumbling around in the darkness of the Plot Assistance Closet. House explains that Adam was buying cheap stop-smoking medicines, which are apparently full of antidepressants, over the internet. House catches himself before he can snark on the suffering parents too much, and even apologizes to them for thinking their son was depressed. He doesn't apologize for anything else, though.
"Did you drop acid?" Cuddy asks as she marches into House's office. House asks her why he would do that. Cuddy has three possible reasons: "To annoy me, or maybe because you're miserable, or because you want to self-destruct?" Why do people feel the need to inform House and the viewing audience that House is so unhappy? And isn't that Wilson's entire purpose on this show? Don't take that away from him, Cuddy. House has a fourth reason: LSD does something to serotonin receptors that makes migraines go away. Cuddy reveals that it was Cameron who tattled on House in the first place, which means that Cameron will go on House's Twenty-Year Revenge Countdown chart just under the anesthesiologist, but Cuddy told her that LSD lasts twelve hours, so there's no way House could have taken it and then been fine so shortly afterward. Unless, House points out, he took enough antidepressants to "short-circuit" the LSD. Cuddy doesn't even know what to say to that. How about "you're fired"?