The Cottages find House sleeping on the floor of his office. Cameron kindly offers him a pillow and only gets criticized for having a "grating" vocal frequency in return. The maggots helped Adam's burns but didn't do anything for his brain, meaning that Cameron's skin-infection theory was wrong. House says that they need to do the lumbar puncture now, and that they can get it by going into the part of Adam's spine that isn't covered with burnt skin -- in between the C2 and C3 vertebrae, which makes this more of a cervical puncture than a lumbar one. Foreman doesn't want to have any part of this, saying that the only time he's ever seen that procedure done resulted in the patient's becoming paralyzed. House says it's either a paralyzed patient or a dead one at this point.
Foreman gets to inform the parents. He tells them that there is a significant risk of paralysis in this procedure that has to be done, and Mom finally speaks up and yells at Foreman for telling her all of this upsetting stuff just to cover his own ass. She'd rather not know it if there's nothing they can do to prevent it. Dad tells her to ease off, and she accuses him of being the reason why Adam is sick in the first place, since that's what he's been saying all along anyway.
Family drama over, Foreman gets ready to do the puncture with Chase assisting. He doesn't have any success with his first attempt and tries again. Chase doesn't think that's wise, and says so loudly and insistently while poor Foreman is trying to concentrate. Adam's blood pressure skyrockets, but Foreman manages to get the tap in and collect the precious, precious fluid.
Foreman comes back to tell House that Adam doesn't have anything they thought he did. They're out of tests for Adam, they've gotten all the medical history from his parents that they can, and they still don't know what's wrong with him. House wants to go right to the source -- Adam. He makes his way into Adam's room with the anesthesiologist and orders him to wake Adam up so he can talk to him. The anesthesiologist really doesn't want to, saying that Adam will be in extreme pain and that this is torture. House orders him to anyway. Adam's first words upon awakening are a gasped "oh my god!" Yeah, burns hurt. I caught a tiny part of my knuckle on a toaster coil the other day and it hurt like anything. House ignores Adam's moans and tells him to answer House's question as quickly as possible before the pain gets even worse than it is now. He needs to know if Adam felt any tingling in his limbs before he crashed the ATV. Adam notices that his chest has been burned off and is upset (they couldn't have at least put some dressings on the guy before waking him up? Cruel!), but manages to keep his head clear enough to tell House that the last thing he remembers before crashing was peeing in his pants. Then he starts screaming in agony, and House lets the anesthesiologist put him back under. House has the grace to look ashamed of himself for what he just did. Or maybe he's just pissed that Adam was so inconsiderate of his migraine and screamed so loudly. He finds Cameron waiting for him outside the room and tells her to round everyone up in his office while he gets some aspirin.