The team takes on the case of Derrick (guest star Skylar Astin), a 19-year-old college student who had a mysterious nose bleed during cheerleading practice, and discovers that his health issues are likely both physiological and psychological. Possibly suffering from schizophrenia, Derrick claims to hear his deceased brother's voice in his head. Wilson becomes resigned to his fate, but House does not. Meanwhile, Foreman tries a different approach with House. All this results in House showing atypical behavior, even for him.