It's graduation week for Princeton College student Carnell Hall, which naturally means one last opportunity to drink ridiculous amounts of booze before heading out into the big wide world. His drinking is interrupted when he suddenly starts experiencing spasms similar to electric shocks. The doctors who try treating him are stumped, and House is eventually referred the case via Wilson.
House — fresh from purchasing himself a motorbike, having tried one out three episodes prior — has more things to worry about than a patient with a mysterious illness, however; his parents are passing through Princeton as part of their holiday, and are insistent on having dinner. House manages to get himself out of it by arranging to instead have dinner with Wilson, but Cameron finds out about this and, wanting to know more about what makes House tick, gets Wilson to invite House's parents to their dinner.
The team finds that the habitual dishonesty between Carnell and his father, Ken makes it difficult for them to get an accurate medical and family history, and leads to a very awkward moment when the team thinks that Carnell's late mother might have suffered a seizure at the wheel of her car and crashed, only for it to turn out that Ken told Carnell that she was killed by a drunk driver in order to dissuade him from ever doing the same (to add insult to injury, this doesn't even end up being the correct diagnosis). Carnell then quietly admits to having taken a trip to Jamaica with several of his rich college buddies, causing House to assume that he smoked weed tainted with pesticides. An attempt at treating Carnell for pesticide poisoning produces a temporary improvement, but he then goes sharply downhill again, with an intestinal bleed requiring surgery on his bowel.
Cameron goes to check up on Taddy, one of Carnell's friends who went to Jamaica with him, and finds that despite him having an embarrassing rash on his groin, he's in otherwise-decent health. House believes the cause to be an STD, but Taddy doesn't want to come in to get tested, leading to much debate between House, Cameron, and Cuddy as to how to get him into the hospital without breaching their ethical code; a problem which soon resolves itself when Taddy is admitted after vomiting blood and collapsing. House finally gets the opportunity to inspect the rash, but finds it not to be consistent with an STD, before Taddy casually mentions that Ken owns a scrap yard, not a construction company as he claimed. House confronts Ken and demands to know if Carnell might have taken anything from the yard recently, to which Ken reveals that he fashioned a keychain out of what he assumed to be an old fishing weight that he found, as a reminder for Carnell never to forget his past. House has Carnell's belongings brought to the radiology lab, and his worst fears are proven true when the keychain — actually a device used in oil rig drilling — turns out to be emitting horrifically dangerous levels of radiation that would be lethal with prolonged exposure. Carnell is suffering from severe radiation poisoning and so, to a lesser extent, are Ken and Taddy, the latter of whom carried Carnell's bag in his lap during the flight to Jamaica.
House's parents finally arrive, with House ironically now having a perfect excuse to avoid dinner, namely a patient who is extremely, possibly terminally ill. They agree on at least grabbing a quick snack in the hospital cafeteria, and during their conversation, we find out that though House and his mother have a good relationship, he and his father, despite a facade of politeness, are decidedly not on good terms.
Carnell undergoes surgery to remove a tumor in his spinal cord, which was the original cause of the spasms he was experiencing. No sooner have they excised the tumor, however, than Carnell's vitals crash once again, the result of another intestinal bleed. Ken's and Taddy's treatment, under Wilson's supervision has produced encouraging results, but Chase then arrives with devastating news — Carnell's immune system has been destroyed, and his internal organs damaged by the radiation exposure. Either one of them would be hard enough to recover from, and the combination of the two is a death sentence. Carnell will be dead in a couple of days at most, and there's nothing anyone can do for him. As Carnell circles the drain, Ken tries convincing him that all will be well, showing that even in their final moments together, they can't be honest with one another.
With House's parents having left the building, he confides in Cameron that his father's "insane moral compass" is the cause of their bad relationship, while Cameron and Wilson in turn confide in one another that seeing their son in such a state is clearly taking its toll on House's parents.
Tropes include:
- Arc Words: Another episode where "everybody lies" is especially pertinent. This time, even House is taken aback by just how dishonest Ken and Carnell are with each other.
- The Dog Bites Back: House offers to immediately repay Wilson the $5,000 he loaned him to buy his motorcycle if he'll call off the dinner with House's parents. Wilson agrees, takes the check... and then drives off without calling off the dinner, much to House's dismay.
- Downer Ending: Carnell is on the verge of death, which will result in Ken being predeceased by both his wife and his son — and knowing that in the latter case, it was entirely his own fault. House's relationship with his parents (chiefly his father) is fraught at best, and clearly isn't improving anytime soon.
- Hope Spot: The treatment for pesticide poisoning seems to be doing the trick for Carnell. Unfortunately, this doesn't last very long.
- Killed Offscreen: We don't see Carnell actually die on-screen, but it's clear in his last scene that he doesn't have long left.
- Missing Mom: It's mentioned early in the episode that Carnell's mother died in a car crash when he was very young. House's team thinks she may have had some genetic condition that her son inherited, but this turns out to be an incorrect assumption.
- Mistaken for Gay: House assumes from Cameron's description of Taddy's rash, as well as its location, that the two are secret lovers, or at least took the chance to experiment with one another. He's wrong, but the rash does turn out to be an important clue after Taddy reveals what Ken actually does for a living.
- Mistaken for Racist: Ken lies about owning a scrap yard, instead claiming to own a construction company, thinking that the hospital staff will give Carnell inferior treatment if they knew about his true history. House calls him out on this, pointing out that failing to give an accurate medical and personal history can be the difference between life and death — and the only reason that doesn't end up being the case here is because Carnell's condition was already terminal before he was even admitted.
- "Not So Different" Remark: House makes one of these while explaining why — alongside the age gap and his general jerkishness — he isn't interested in a relationship with Cameron. Her extreme and uncompromising sense of morality is just too reminiscent of his father for House's liking.
- Oh, Crap!: Foreman's reaction when the radiation detector that House is holding starts going crazy when he waves it across the keychain on Carnell's backpack.
- Red Herring: The death of Carnell's mother during his childhood is believed by the team to possibly have some significance, but it turns out that their theory was incorrect, and that she probably just fell asleep at the wheel.
- Ripped from the Headlines: Carnell's getting radiation poisoning from an object found in his father's scrap yard was inspired by an incident in Brazil in the late 1980s, which ended up claiming the lives of four employees and family members of a scrap yard owner.
- Single-Issue Wonk: Both of the fathers seen in the episode:
- For Ken, refusing to let Carnell drift too far away from his roots, firstly by refusing to let Carnell use his breaks to actually have a break and putting him to work in his scrap yard, secondly by forbidding him to fraternize too much with his richer friends (which Carnell ignores), and thirdly, by giving him the keychain as a gift and presumably making Carnell carry it somewhere on his person at all times.
- In John's case, it's always demanding the truth from other people (and in turn, delivering it to them), no matter how uncomfortable it might get. As House lampshades, that might be a good quality in a soldier, where honesty can mean the difference between life and death, but it's not so good for a father.
- Spotting the Thread: Taddy's casual mention that Carnell has to work in his father's scrap yard whenever he's home for a break leads House to infer the Awful Truth behind this particular case.
- Tragic Mistake: One of the biggest examples in the series, with Ken's unknowingly fashioning a keychain for Carnell out of some extremely radioactive material ultimately leading to a fatal case of radiation poisoning. His lying about owning a construction company instead of a scrap yard would also have been this, if not for the fact that Carnell was probably too far gone by the time he started showing symptoms, though it could well have resulted in both Taddy and himself dying prematurely if House hadn't worked out what was wrong with Carnell.
