Mickey and his friend Eddie sought out treatment for the facial lacerations Mickey suffered when he collapsed onto the concrete floor of a garage. At Princeton-Plainsboro Teaching Hospital, he was treated by Dr. House who wanted to perform a CT Scan to ensure that Mickey hadn't suffered a serious head injury. Mickey refused to discuss how he got injured. However, he insisted that although he had a headache he wasn't feeling dizzy and he demanded to be treated and released. Dr. House kept questioning Mickey and Eddie, noting that they had not gone to the emergency room for treatment, most likely because a lot of police officers are there for one reason or another. However, neither Mickey nor Tommy was forthcoming. Dr. House noted that Mickey had no scrapes on his hands, which meant he didn't try to brace himself as he fell. He was most likely unconscious before he fell. He also noted that apart from the cut on his head, there was no sign of trauma, which meant he wasn't hit in the head. He also noticed a powder burn on his sleeve, meaning that he had been near a gun when it was fired. Mickey got up to leave, but Dr. House said he didn't care what they were up to but if Mickey didn't get a full work up it would happen again. To prove his point, he smashed a table with his cane to make a loud noise. Mickey collapsed again.
Dr. House described the case to his team, explaining that Mickey had vertigo that was induced by loud noise. His CT Scan was clean and there was no internal bleeding or edema. The only history they had was that the patient had admitted straining his back three years before. Dr. House explained that Mickey was probably a drug dealer - he was wearing gold, Tommy had a Rolex and their cell phones were prepaid. Dr. Foreman noted that since the vertigo was noise induced, it had to be something wrong with his ear or brain. Acoustic neuroma was most likely. Dr. House thought it might be lidocaine toxicity. He ordered his team to test Mickey's ears while he went to get a cocaine sample to see if it was cut with lytocaine.
Dr. Taub explained the procedure to Mickey and told him that the test shouldn't take more than 90 minutes. There were some minor anomalies, but nothing serious.
Dr. House was trying to get a drug sample from Eddie. They finally agreed to talk in code. Eddie denied that Mickey worked with the cocaine, he just sold it. He also hates using it, which is why Eddie trusts him.
However, during the ear test, Mickey had a seizure. His heart rate was irregular although his airway remained clear. Dr. Foreman called for a crash cart. Mickey's blood pressure started to rise and Dr. Taub realized they had to lower it before he had a stroke. Dr. Taub put him on vasodilators and got it under control. Dr. Hadley noted that Mickey got worse in the hospital, so it probably wasn't anything related to his drug dealing that made him sick. Dr. Chase thought it might be sick sinus syndrome, but Dr. Taub noted that Mickey had no chest pain or shortness of breath. He though it might be a brain aneurysm secondary to polycystic kidney disease. However, Dr. Foreman noted that Mickey's urinalysis was normal and his kidney was palpable. Dr. Hadley suggested carotid stenosis. Dr. House agreed and ordered an ultrasound of his carotid arteries to see if they were clogged.
However, the ultrasound showed no obstructions or narrowing. He also kept asking to be discharged. In order to try to get a better medical history and find some drugs to test, Dr. House attempted to use a listening device in the patient's room, but he could not get it to work. However, he figured that toxins were being released by Mickey's fat cells which is why he was getting worse in hospital. Dr. Taub suggested that if it were a toxin, they should start testing him. However, that gave Dr. House an idea - he told Dr. Taub to tell Mickey the necessary tests could take several weeks. Mickey insisted on being discharged and Dr. Taub agreed. Dr. House had Dr. Hadley and Dr. Chase follow Mickey to see where he was going. However, Mickey managed to lose them.
However, Mickey was soon back in the hospital with a fever of 105F combined with a weak and thready pulse. Eddie told the doctors that Mickey was delirious as well. They had to physically restrain Mickey to keep him on the hospital bed.
Mickey was given anti-pyretics and mild steroids. His fever dropped and he came out of his delirious state. Dr. Chase pointed out that the fact he now got worse after leaving the hospital indicated it was something environmental. However, Dr. House disagreed. Given the rapid onset of the fever, infection was more likely and it had likely spread to his brain. Dr. Chase and Dr. Taub went to do a lumbar puncture.
Mickey apologized for having to lose them. He also complained that the doctors had a bad attitude about his drug dealing, alhtough it was more likely that they treated far more people with alcohol issues rather than drug issues. Dr. Taub had difficulty finding an entry point as the prior back injury seemed to have flattened out his discs. As they completed the procedure, Dr. Chase realized that Mickey's heart rate remained normal, even though it should have gone up due to the discomfort of the procedure.
Dr. Chase told Dr. House that they had ruled out infection, but that given the normal heart rate it might be an autonomic nerve disorder. However, Dr. House realized it wasn't due to his underlying problem - Mickey was taking beta-blockers. Mickey admitted that he took them to control the symptoms of the stress he feels from his lifestyle. He didn't want his friends to know. He admitted he took one the night before he was admitted. Dr. House realized the high blood pressure was merely a symptom of withdrawal. When he left the hospital, he took another beta-blocker, which allowed his blood pressure to return to normal. Dr. Chase noted his stress could be a symptom and Dr. House agreed he might have a pheochromocytoma - an insulin producing tumor. Dr. House ordered Dr. Chase to do an MRI of Mickey's adrenal glands.
The MRI was negative, meaning the stress wasn't a symptom of an underlying pathology. Dr. Taub wanted to look for environmental causes. Dr. Hadley was trying to get the listening device to work. However, she had no better luck. All of a sudden, Dr. House realized the reason the device wasn't working was because there was no open frequency. He went down to Mickey's room and asked Tommy to leave so he could give Mickey a rectal exam. However, once he left, he asked Mickey why he didn't just take Xanax or Valium to actually reduce his stress rather than beta blockers to alleviate the symptoms. He noted that actors often take beta blockers so they remain alert but have no outward symptoms of fear. He started to search Mickey's room and found a listening device he hadn't planted there. Dr. Hadley thought that Mickey might be a police informant, but Dr. House said an informant would never try to protect his colleagues and that Mickey had to be an undercover police officer. It explained why he was so hesitiant to give a full history.
Dr. Hadley went in to see "Mickey" to tell him they would find out who he was and speak to his supervisor, but he noted that they knew too little about him. He said he needed to find out who the boss was before he expanded his operation. They were only a day away and if the doctors interfered the meeting would be aborted and sixteen months of his life would have been for nothing. He asked them to keep him alive for 24 hours, then he would tell them anything they wanted to know.
When Eddie returned, Mickey started having severe abdominal pain. They traced it to an digestive tract infarction due to a clot in his superior mesenteric artery. They did surgery to remove a foot of his small intestine. Dr. Foreman noted they had ruled out cancer and infection and that Mickey got worse on steroids so it probably wasn't autoimmune. It still pointed to an environmental cause. Dr. Foreman wanted to treat Mickey for the most likely environmental diseases, but Dr. Hadley pointed out that so many treatments could kill him faster than the actual disease could. She suggested that if Eddie believed he was sick, he might be more likely to talk. She drugged him and tried to convince him that he had the same thing Mickey had, but Eddie had been drugged so many times before that he realized what Dr. Hadley had done. However, he still agreed to take Dr. Hadley to where they were keeping the drugs because he was afraid Mickey was going to die.
The drugs were stored in a dry cleaning facility so Dr. Hadley started taking samples. They were interrupted but they managed to bluff their way out of it. However, all the samples came up clean. Dr. Hadley thought it was probably the dry cleaning chemicals, perchloroethylene, and Dr. Foreman had already started Mickey on inhaled albuterol. However, it wasn't helping and Mickey was now coughing up blood. Dr. Taub wanted to use ipratroprium as well, but Dr. Hadley discovered the chemicals were only petroleum solvents, a more environmentally friendly alternative that wasn't toxic.
Dr. Chase did a VQ Scan of the lungs which showed an aneuyrism which had been treated. However, a later scan showed three more. Dr. Foreman thought the aneuyrisms looked mycotic, indicating a fungus. Dr. Hadley denied there were any fungi at the dry cleaner, but Dr. House thought she had missed it. Dr. Hadley countered that if it were a fungus, the steroids would have allowed it to spread faster and he should have thirty aneuyrisms by now. Dr. House agreed. Dr. Foreman wanted to start him on anti-fungal medication and Dr. House agreed.
Eddie went to the big meeting at Mickey's insistence. After he left, Dr. House realized that the aneurysims may have looked mycotic, but they were actually inflammatory. The high blood pressure was a real symptom that was unwittingly being suppressed by the beta-blockers. When he stopped taking them, it wasn't withdrawal but his blood pressure returning to its actual level. He had Hughes-Stovin syndrome, an autoimmune disease. Given its advanced stage, it was terminal. He would keep getting aneurysms until one of them ruptured and he died. Dr. Hadley told him that he was probably terminal when he arrived at the hospital. He asked to call his wife. After she arrived, his symptoms continued to get worse and he finally died.