House goes to Cuddy's office. She stands, bracing herself for impact, but he isn't there to yell and scream at her; he has to pull himself off of Harpo's case. "I'm losing my mind," he says. Cuddy isn't sympathetic, accusing House of doing this to scare her and make her feel bad about what she did to him. House asks Cuddy why she jumped up when he entered the room. "I thought you were gonna attack me again," she says. "Again?" he asks. He only hallucinated that scene with her and Wilson in the office. Which means that he's hallucinating right now, too.
House opens his eyes. He's still in his hospital bed. He turns to see Shooter McGavin smiling at him like a creep.
After the commercial, Shooter and House take a lunch break at House's favorite taco stand. House has already figured out that this a hallucination, too, which means that he can eat all the tacos he wants and never get fat! It also means that Shooter is just a figment of House's imagination and therefore when he talks to Shooter, he's just talking to himself and not the guy who tried to kill him. "How can I tell what's real?" House says. Shooter says that as long as House doesn't act on any of his ideas, he can't hurt anyone. He can keep throwing out the ideas to his team, but if they're based on a hallucination and not reality, the Cottages will point that out to him and refuse to act on it. We hope. And doubt.
Back in the physical therapy room, House decides that they'll have to do more than biopsies, which aren't always accurate. House bases this on the analogy that if you go "down the shore" (what up, Jersey in the house!) and fill a cup of ocean water, you won't find any fish in it. Obviously, that doesn't mean that there aren't any fish in the ocean. They need a bigger sample. Chase agrees with what HallucinationCameron said before: they can't operate on Harpo to really see what he's got going on inside his body because of his bleeding problem. Foreman agrees with HallucinationForeman that they don't even know for sure whether Harpo has a bleeding problem. Chase has had two facefuls of bleeding-caused exploding body parts, though, so he knows better than anyone that Harpo has a bleeding problem and they can't operate on him. Unless, that is, they can find a way to do the surgery without having to cut him open.