With no diagnoses from the underlings and no dinner plans from Cuddy, House heads for James' room in the hopes that his computer-like mind will help him come up with the correct diagnosis. "I don't have anyone else to ask," House says a bit sadly. James knows how he feels, being a lonely super-genius himself. He asks if House ever tried to kill himself. "Not quickly," House says, which is about right. James, on the other hand, did try to kill himself quickly by jumping off an eight story building 12 years ago. Despite being a super-genius, he landed in the dumpster the day before trash pickup, and so did not die. He wound up in the hospital with broken bones galore and a special reward for all of his hard work: painkillers! James realized that he was much happier when he on mind-dulling drugs, and it's also where he met Dara, who he fell in love with because she was "so happy. And dumb." He decided that the only way to be happy was to be dumb, and that meant taking cough medicine for the past 12 years. Um, okay. That's kind of out there but the patient and his dilemma interested me enough to accept it. It also makes me think that whoever wrote this saw that episode of Intervention with the guy who was a genius but got addicted to cough medicine and lived in his mom's basement. With that, House decides to perform his one kind deed of the episode and hand James a bottle of cough medicine so he can be a happy and stupid drug addict again. He turns to leave the room, only to get a second epiphany in one episode. He spins around and asks James which ribs he broke in his suicide attempt. James says it was the bottom three on his left side, but House already knew that.
House calls the Cottages in to watch as he performs some kind of scan on James that will show his spleen. Taub grumbles that the late-night page is probably going to cost him his marriage before House grabs him to use as a human shield against Chase, who isn't going to punch him but also isn't pleased to hear that House thinks James has a spleen, considering the fact that Chase was the one who removed it. As it turns out, House isn't doubting Chase's surgical skills -- he's just doubting Chase's powers of observation, as while he did manage to take out a spleen, he missed the fact that there were sixteen more of them in there. What? Yes, it's true: apparently, the spleen is awesome and can split off into splinter spleens if damaged, like it was when James broke those ribs. So James did have TTP after all, and removing the rest of his spleens should make him all better.