When we return from those awesome opening credits, the guy is stuck in bed with a ventilator shoved down his throat. Foreman says that when the sedative wore off, he was still screaming, so they had to put him back down again. House asks for a differential diagnosis on a guy who's psychotic, dizzy, and has pain in his right ear. Chase and Cameron ask House where he gets the dizziness and right ear pain from; House says that the guy was dizzy, therefore the pain was in his ear. Cameron says that just because the guy was running around in circles doesn't mean he was dizzy, and House criticizes the imperfect circles the guy was running in, like I'm sure Mr. No-Thigh could do any better. Foreman guesses a hemorrhage, and House says that explains everything and tells them to do an MRI. They start to stand, but House wants more diagnoses. Chase says that the guy might be psychotic and pulled a Van Gogh and damaged his ear, causing the dizziness and pain. "Excellent!" says House. Chase puffs up with pride, apparently not noticing House's total lack of sincerity. He orders a psychiatric workup on the patient, and then demands a diagnosis from Cameron. She says that she was going to guess what Foreman said. Ha! I've done that in class before, too. House tells her to say something else, and she checks out the file and says that maybe the guy just had a really bad ear infection and it exploded through some ear bone while he was waiting in the Clinic. It would be cool if that were what happened, because it would mean that House's yelling at people and refusing to examine them actually made someone's head explode. House orders a CT scan and blood cultures.
As the Cottages are on their way out, House tells them also to pour some alcohol in the guy's ear and take the cockroach out. Yes, that's right -- the guy just had a cockroach in his ear, which House noticed when he took the guy down, but decided not to tell anyone because having a new patient would get him out of Clinic duty. Really, House? What the hell is this guy's insurance provider going to say when they see charges for a fucking VENTILATOR because the guy had a cockroach in his ear? Not to mention that the poor guy had to go through having his lungs PARALYZED while he was conscious for NO REASON. Plus, the guy had that cockroach in his ear for a lot longer than it had to be, and it was obviously causing him incredible pain that whole time. And if it was biting him, it may have caused irreparable damage to his ear. All because House didn't want to do a measly two days of Clinic duty. Such an asshole. Oh, and if you think that cockroaches in the ear aren't common, this happened to a co-worker of mine once. A beetle crawled into her ear while she was sleeping and she had to go to an ER to get it out. She said that it was really painful and horrible. I said that beetles often chose warm, tight spaces to lay their eggs in, and that maybe, in a few weeks, we'd get to see a whole bunch of baby beetles come flying out of her ear. I was kidding, but she didn't seem to think that was very funny. She got me back, though, when a donkey at a petting zoo bit my arm and left a bruise and she said that petting zoo donkeys often carry rabies. The moral of the story is that you should wear earplugs to bed and not assume that all petting-zoos animals actually liked being petted. And now you know.