House and his new old team take the case of James, a brilliant physicist who left it all behind to marry a woman and embark on a career delivering packages and comes to PPTH because he can't move his hand. They get right to diagnosing him with thrombotic thrombocytopenic purpura (TTP) and removing his spleen to treat it, only for his condition to get worse with a stroke. House eventually realizes that James is addicted to cough medicine because it makes him dumb and, therefore, happy and in love with his less intelligent wife. But since it's causing his symptoms, he has to quit it and go back to his brilliant but lonely life. Except then he can't feel his legs, which means it wasn't the cough medicine after all. When James tells House about a past suicide attempt that left him with broken ribs and the realization that drugs made him feel wonderfully stupid, House finally figures out that it was TTP the entire time, and removing James' spleen didn't work because the suicide attempt trauma injured his spleen, causing it to become awesome and split up into 16 mini-spleens! Once they're all removed, James is cleared to go back to his life of cough medicine abuse and stupid-wife-loving. And for our non-patient plots, House and Cuddy play mind games with each other and the audience loses, Chase gets his co-workers to stop being nice and asking him about Cameron by punching House in the face, and Taub uses House's resulting facial trauma to prove to his wife that he can stand up to his boss with violence, which she finds irresistible for some reason.
A delivery man enters the dustiest library of all time and chats with the librarian, who sort of brags that he understands "most" of the library's egghead books. He's not lying, though, as he recognizes the delivery man as James Sidas, the youngest person ever to graduate MIT with a reported IQ of 178 and three books and thirty-five academic papers published before he was 18. James is less than thrilled to be recognized, but the librarian doesn't care, asking him to sign one of his books and saying James' presence there is "the most exciting thing that's happened in this place in years." "I'm not that guy anymore," James says. Seriously, librarian -- he's a per diem delivery man. Obviously, something's gone wrong. Leave him alone. But James agrees to sign the book to get the guy off his back, only to find that his hand isn't working.
And even though Cameron is off the show, the credits stay the same!
House brings a bagel to the PPTH cafeteria register and tells the woman behind it to put it on Wilson's tab. The cashier isn't having any of this, saying she doesn't know who Wilson is and they don't have tabs, anyway. House then attempts to steal the bagel, but Cuddy is there to pay for it. This traps her in a conversation with House, who asks about her Thanksgiving plans. She says she's going to her sister's house and gives House James' file, which he takes without question or complaint. "Enjoy your drumstick!" he calls back pleasantly on his way to work. Cuddy responds by cocking her head so far to one side that I thought her neck might be broken.
House limps into the meeting room, where the current team is ready and waiting. Yes, there's Chase, wedding ring-free! He certainly did give up on and get over Cameron quickly, didn't he? House tosses the file on the table and says their latest case is a courier with ataxia, anemia, and a mild cough. He gets the Cottages' brains in gear with a mild jab at Foreman's race and chews on his bagel. Taub comes up with a diagnosis of sickle cell anemia, which Foreman frowns about because James is white, and thus much less likely to have sickle cell. But not completely unlikely, Foreman. Expand your disease horizons. He has a better diagnosis, though -- thrombotic thrombocytopenic purpura, or TTP, which Hadley agrees with, much to everyone's surprise. You see, they assumed that Hadley and Foreman would have a hostile working relationship, but it turns out that Hadley and Foreman are committed to acting like professionals and adults unlike everyone else on this show. Chase likes TTP too, but Taub disagrees. House ignores him and tells them to confirm the TTP diagnosis with a blood test.