We open at a book tour kickoff dinner. The author has to give a speech, which he apparently didn't expect and isn't very good at, using most of it to wonder what he's supposed to say. Nick, his editor, suggests thanking people, and author Tim starts with Nick, thanking him for being a good editor and for doing a lot of necessary hand-holding to bolster Tim's apparent lack of confidence. As the room toasts to Tim's collection of short stories being another best-seller, Nick suddenly decides to stop holding his hand and says there's no way short stories will sell since they haven't made money since 1908, which seems to be the time period Tim is recalling with his hairstyle. Nick continues that the publisher only put the book out so as not to offend their star author. Nick's wife decides to step in at this point and says his name warningly, and Nick seemingly snaps out of it and apologizes. But then he keeps going, turning on the publisher and criticizing both her people and her mothering skills. And with that, he gets a bloody nose and collapses, but not before hating on the title of Tim's book.
Cameron brings the case to House's attention off-camera, and by the time House arrives at work, the Cottages are all a-twitter over their chance to take on a case reminiscent of Phineas Gage, who survived a large railroad spike being blown through his head only to emerge with a very different personality due to frontal lobe disinhibition. Nick also has frontal lobe disinhibition, and he didn't even need a railroad spike to get it. So worry not, people who want frontal lobe disinhibition but are worried that the decreasing use of trains in modern day America means less railroad spikes to accidentally blow through your skulls -- it's still possible. Foreman cheerfully reports that the MRI didn't show anything to explain Nick's problem, even though that goes without saying. The only thing that MRI is good for is murder. Hadley suggests that Nick has a tumor in his nasal cavity eroding into the brain that the MRI was not able to see somehow. House sends the Cottages off to stick a scope up Nick's nose and look around for tumors.
Nick is in bed playing cards with his young daughter, who says he's going to keep losing their game if he insists on telling what his cards are. Is he telling her because of his frontal lobe issues or because he's one of those dads who insist on letting their kids win? I did not have one of those dads. He even beat us at Dizzy Dizzy Dinosaur. Kumar and Taub have to interrupt, and Kumar apologizes with a big smile on his face. "You don't look sorry!" Nick says. "Um ... no offense. Although you do look kind of cheerful. A little creepy." He then wonders if he should switch to a doctor who isn't all giddy about how sick he is. I see nothing wrong with what Nick is saying to Kumar right now. I'd be pissed too, if I just essentially lost my job because I was unable to keep my mouth shut and some doctor who can't be bothered to dress professionally was grinning in my face about the prospect of sticking something up my nose. Taub saves Kumar, explaining the test to Nick. He asks the daughter to get lost, but she doesn't move. The wife is nearby all of the sudden, and speaks up to say their daughter, Marika, has an "auditory processing disorder." That seems to mean that everything has to be spelled out for her in very clear terms.