House enters his office, where he finds Hadley waiting for him. She says Spencer signed the consent form. But House doesn't want to talk about Spencer now. He wants to discuss Hadley and her downward spiral of destruction. Whoa, flashbacks to 7th Heaven and Mary Camden's own downward spiral of treacherous road works. Can you imagine how great that would have been if it had been anything like Hadley's? House says Hadley's downward spiral is only going to get worse as she pushes away anyone and everyone who cares about her. "Anyone" is right. Does Hadley have any friends or family? Not that we've seen! House graciously offers her her job back, even though he says he knows she won't get any better, behavior or health-wise. WHAT? NO! SUCK. Hadley is shocked, but House says she did good work. Hadley says she did good work yesterday, too. Yes, well, perhaps it took two days for House to realize that Hadley wasn't going to leave the hospital no matter what, so he might as well give her her job back. Or maybe he got a letter from the American Disabilities Act people threatening to sue him for firing someone with Huntington's. Whatever. It is nothing short of cruel of the writers to keep me hanging on like this, hoping against hope that the firing might actually stick. How could you, Sara Hess and Liz Friedman? Of course, it turns out that House never really meant to fire Hadley permanently -- just make her think so so she'd have time to bond with Spencer over their terminal illness. Hadley gets all angry at House for manipulating her (I believe that was his way of being sensitive and trying to help, though. Give him a break, Hadley), but House is distracted by her cracked lips. Yes, well, Ecstasy dehydrates you and Hadley probably has mouth herpes. I wouldn't find it at all unusual. But it gives House his epiphany. He asks Hadley if she's used her inhaler lately (yes) and if Spencer cried upon receiving the bad news (no).
With that, House slams an onion down on Spencer's bedside table and starts chopping. While he and Hadley's eyes tear up, Spencer's do not. Therefore, she cannot produce tears. That's one way to test it. Another would be to tell her that an annoying and useless character on her favorite show who gets all the screen time has been fired, lead her on for a while, and then reveal that she's been hired back after all. Sniff! This gives House the diagnosis of Sjorgen's syndrome, an autoimmune disorder that attacks the glands that produce tears and saliva, causing them to dry up. It also somehow causes all of Spencer's other symptoms. Except for the smooth muscle in the lung cysts. It doesn't cause that. I guess we'll just chalk it up to someone screwing up the biopsy? And how did House arrive at this diagnosis through Hadley's cracked lips? Well, he explains that a dry mouth is a breeding ground for bacteria, while inhaler use somehow wipes out the mouth's immune system. Therefore, an opportunistic infection in Spencer's dry mouth was easily spread to Hadley's, causing her lips to crack. Okay, that is a stretch. House is just thrilled that he can say that a lesbian makeout saved Spencer's life. She won't have a deadly marrow transplant and Sjorgen's is perfectly treatable and not at all terminal.