Patrick Obyedkov (guest star Dave Matthews), a 35-year-old musical savant, is in the middle of playing a piano concert when he suffers a painful involuntary muscle contraction in his left hand. After Patrick is admitted to Princeton-Plainsboro Hospital with a rare movement disorder, his case attracts the attention of Dr. House. House learns from Patrick's father, Dr. Obyedkov (guest star Kurtwood Smith), that Patrick suffered severe brain damage at age 10 from a bus accident that also killed his mother. House is intrigued as to why Patrick, who was a healthy 10-year-old at the time of his accident with no prior musical training, could suddenly play the piano flawlessly after suffering a severe injury. He pushes for further testing on Patrick's brain even though the team has diagnosed him with a simple muscle-contraction problem. While trying to deduce the origin of the brain rewiring responsible for Patrick's mysterious gift of music, House and his team must stop the deadly bleeding that is quickly threatening his life. Patrick's condition worsens as he suffers an onset of seizures, and as the team attempts to stabilize him, House presents a very difficult option to Patrick's father – a neurological procedure that would change Patrick's life forever. In the meantime, Cameron discovers that House has been in contact with a hospital in Massachusetts and suspects that House may be looking to take a new job there. When Cuddy contacts the hospital, she learns that House has been in contact with a brain cancer specialist – not as a job applicant, but as a patient for a clinical trial. When confronted by his team, House denies the gravity of the situation and resents their interference, and they are forced to contend with the possibility his condition may be more serious than he's letting on.