Patrick Obyedkov, a brain-damaged savant who gained extraordinary piano ability after a childhood accident, develops dystonia during a performance. House admits him to investigate the impossible neurology, which leads to a discovery of autoimmune disease and a radical surgical proposal: remove his dead right hemisphere and end his seizures — at the cost of his ability to play. Meanwhile, Cameron finds plane tickets to Boston in House's mail, and the team uncovers what looks like a terminal cancer diagnosis.

The episode uses the savant case as a structural mirror for House's own situation — a man defined by a single extraordinary ability, surrounded by people who care, unable to access ordinary life. The cancer revelation turns out to be an elaborate deception, and what it exposes about House is more damaging than the diagnosis would have be ...