House has to decide who out of the 40 applicants will become part of his new diagnostic team.
In the season premiere, House must diagnose a young woman who survived a building collapse but is now suffering from a mysterious fever. Without the help of his old team, House is determined to cure the patient by himself – but a series of ever-more alarming symptoms suggests the case is not all that it seems.
At the close of season three, House was left without his diagnostic team after firing Chase and watching Foreman and Cameron walk out on him. The new season finds House in the unfamiliar position of flying solo – and refusing to take the advice of Cuddy and Wilson when they urge him to hire a new team.
Determined to get House back to work, Cuddy hands him the case of Megan Bradberry, a young woman who was seriously injured and disfigured in a building collapse. Megan is unconscious and suffering from a high fever that drugs are doing little to abate. House takes to his whiteboard to begin his usual process of brainstorming, but finds he needs a passing janitor to act as a sounding board.
House dresses his new sidekick in a white coat and gets him to pose as a doctor when they talk to Megan’s boyfriend, Ben, and mother. But the janitor refuses to join him on a break-in of Megan’s house to search for clues, so House takes Wilson instead. At the house, they discover Megan’s diary, which indicates she may have been depressed and, therefore, taking medication. Ben is bewildered by the news, but House treats Megan according to his theory and she regains consciousness. Unable to speak, the girl confirms by blinking that she was on antidepressants.
However, a complication arises when Megan suffers a seizure and is resuscitated, only for the fever to return. Ben is astonished when House diagnoses her with delirium tremens and declares she must be an alcoholic. “This is insane. You don’t think I’d have noticed her being constantly drunk?” he says. House treats Megan for the DTs until Cuddy notices that she is in extreme pain. She diagnoses pancreatitis and claims that House is losing his grip on the case. “You need someone to bounce ideas off. You need a team!” she says. To prove her point, Cuddy refuses to "enable” House by listening to his ideas, forcing him to work alone.
But an MRI scan baffles everyone when it shows that this latest problem is not pancreatitis, but internal bleeding. House, meanwhile, discovers evidence that Megan recently had an abortion and was on birth control pills – another revelation that her boyfriend refuses to accept. “Either she lied to you or her blood lied to us,” House says simply.
Megan’s bleeding improves but her mystifying symptoms continue when she suffers an allergic reaction to a drug that she has apparently taken before. “What is this hospital doing to her?” Megan’s mother asks. “She has had three separate medical disasters and now she’s dying of an allergy she can’t possibly have!” House finally realises that Megan’s symptoms and her secret history of depression, alcoholism and abortion can only be explained if she is not who she seems to be.
Also this week, Wilson hits House where he knows it will hurt when he kidnaps his beloved guitar and refuses to return it until his friend hires a new team. But House’s humourless response to the “kidnapping” prompts Wilson to question his real reason for wanting to go it alone. Is House feeling abandoned by his protégés? “You got hurt,” Wilson says. “Get over it.”