Never let it be said that famous patients don't get special privileges, as Giles plays CDs on his own personal stereo. (Please don't bother emailing me about how when you were in the hospital this one time, they let you have all manner of electronic devices.) Foreman draws some blood. Giles turns the music off because he likes to have his deep discussions in silence. He asks if the pneumonia means that his ALS is getting worse. Foreman says it looks like it. Giles wonders if he'll die in New Jersey or make it back to L.A. Wow, both of those choices suck. He'd better hope he dies on the plane ride. Foreman says that an MRI might give them more information, but Giles ain't buying it. You don't do MRIs for pneumonia. Foreman admits that it was House's idea, and Giles has actually heard of House because he apparently reads medical journals when he isn't playing his trumpet. "Obsessive sunnuvabitch?" he asks. Foreman says that is House indeed. Giles asks Foreman who's right: Hamilton and the ALS diagnosis, or House and the not-ALS diagnosis? Foreman reluctantly says that "everything points to the ALS." In that case, says Giles, he will not consent to the MRI and he would like to sign a Do Not Resuscitate order. Way to get a second opinion, there, champ.
House lies on his floor and loses himself in a world of music, listening to some of Giles's greatest hits on vinyl, the way they were meant to be heard. Foreman enters and informs House that Giles just signed a DNR. House says that most people who think they have a terminal degenerative disease would do the same, but that if he were the lead on this case, he'd be giving Giles some intravenous immunoglobulin therapy, which would cure Giles if he had multifocal motor neuropathy. Foreman says thattGiles doesn't want any treatment. House says that a DNR doesn't mean you can't treat a patient while he's still alive. But if Foreman's planning on doing nothing, he might as well hang on to that DNR, because the signature on it will be worth a lot of money soon. You know, because Giles will be dead.
Foreman walks out of House's office and immediately calls someone to order the immunoglobulin. Aw, he loves House just as much as the other Cottages do!
Clinic time! A patient's "little guy" is having problems standing up lately, and it would like some Viagra. House finds it annoying that his patient insists on referring to his penis in the third person, and says that Viagra is not the best idea for someone who is cheating on the diabetes he doesn't want anyone to know he has. House says that the guy's hands and feet show signs of diabetes-caused nerve damage, while his pants show signs of multiple powdered donut ingestion. House has to cut the insults short, though, as he gets a page for a Code Blue in Giles's room. He gives the patient a prescription for the Viagra, saying it won't kill him any more than the heart disease he gets for ignoring his diabetes will, so he might as well go out having fun. Did House just give that guy a death sentence on a prescription pad? Well, all I could find out in a brief online search is that for men with untreated diabetes, Viagra "may not be the best match for your other health needs," so I don't know. But as we'll soon see, House isn't the most respectful guy in the world when it comes to medical ethics.