Moriarty: How did he know that?

House: I wouldn't have hired him if he wasn't smart.

Moriarty: Right. Because you have nothing but respect for him. Maybe he knew the answer because the question wasn't nearly as tricky as you thought. Maybe he's not getting smarter; you're getting dumber

— No Reason

No Reason is the 2nd season finale of House which first aired on May 23, 2006. After a former patient shoots House, House awakens to find the shooter in the next bed. He also finds that he's been given an experimental treatment that has gotten rid of his leg pain, but may have also affected his mind. Meanwhile, the team tries to treat a patient whose test results keep coming up negative even as his bizarre array of symptoms continue to get worse. As the shooter continues to confront him about his seemingly diminishing mental skills and lack of humility, House figures that something is seriously wrong and that must solve the puzzle posed by the other patient in order to get things back to normal.

Although there were episodes that allowed us into House's thought processes throughout the series, this episode is the first of that kind - a glimpse into House's head. House's personality dominates the series and, although we always have the feeling that he's putting up an elaborate front, it is only through episodes like these that we see completely through House's outer personality.

We do get glimpses into House's full personality in most episodes, starting with his meeting with Rebecca Adler in Pilot. However, although it takes a while for the viewer to realize that the events after the shooting may all be in House's mind, it is the first time that we are treated to what is essentially an entire episode where House's thought processes are laid bare. Instead of the confident and sarcastic House we're used to, instead we see uncertainty, fear, and even a little humility.

We have always suspected House is highly self-actualized, as is typical for an introvert loner left alone to work things out on his own. A peek into his "inner dialogue" shows a previously hidden depth to this side of House. As soon as "normal" House pumps himself up, "the loyal opposition" is right there to tear him back down again. As in other episodes that use the same theme, House's "other side" is embodied in a different person. Here, its the man who shot him. Later, it becomes Amber Volakis. The role is the same - it's House talking to himself.

And House has always been harder on himself than anyone else could be. Although House often tries to justify his bad behavior, when he realizes he's stepped over the line he's set for himself, no one is harder on him. This side of him is fully explored in Season 8 when he spends a year in prison when he could easily have avoided jail time with a little work.

But the real fear here is also explored later on in The Softer Side where once again House is given the choice of living pain free or keeping his "gift". Once again, he's terribly afraid that the two are tied together and that he will somehow lose himself when he loses his pain. However, resolving this conflict is in this episode, as it is in the rest of the series, the way House finds his way out of the trap and finally finds at least a little bit of peace.

While House is doing a differential on a patient with a badly swollen tongue, a man claiming to be a former patient of his comes in and shoots him twice.

House wakes up in intensive care and finds Cameron next to him. Cameron lies that she hasn't been there the whole time. She tells House about the bullet wounds. He asks about the patient with the swollen tongue. She tells him that they haven't diagnosed him yet. They wheel in the shooter, who has been shot by security.

House decides to walk out of the room, his leg pain killed by the morphine he's on for the trauma. He tells Cameron to biopsy the swollen tongue patient's lymph nodes.

Cuddy tells House that having the shooter in the same room is unavoidable. Cuddy tells House not to up his morphine, but instead he is lowering it. He can't understand why his leg doesn't hurt when everything else does. Cuddy tells him to go back to intensive care. But does he listen?

House goes back and lowers the shooter's morphine. He asks why the shooter tried to kill him. The shooter says he didn't mean to kill him, only make him suffer. House shuts off the shooter's morphine.

The team does the lymph node biopsy on the tongue patient, but it's negative. The patient starts suffocating and they have to do an emergency tracheotomy. House gets a copy of his own operative records. The team thinks the tongue patient has an infection, and House orders a lumbar puncture despite the risks. Chase stands up for the decision because when they decided not to do one earlier, they at least had other choices. Foreman performs the lumbar puncture.

The shooter starts talking about his wife, who was a former patient of House. She survived, but the shooter had to admit he had cheated on her. However, that confession had nothing to do with her condition, and House told her anyway. She killed herself over the affair.

House goes to see the swollen tongue patient, and meets his wife. He is surprised that she is so much better looking than the patient is, but tells her that he might have an STD and asks her to confess to any affairs. She denies having any.

After the lumbar puncture, the patient starts bleeding into his eye, which starts to pop out. House notices at the time his own stitches have torn out, and he collapses on the floor.

House and the shooter are back in intensive care having breakfast. House is restrained to his bed by handcuffs. They discuss his (the shooter's) wife's suicide and why the shooter is blaming House. The shooter admits it's his own fault his wife is dead, but House refuses to take any blame.

House decides the swollen tongue is not an infection, it must be a bleeding disorder. Since his team won't discuss the case with him, he starts impersonating their reactions. He orders a biopsy of the blood-brain barrier. They start talking about STDs, and House says he doesn't think the wife is cheating. The team tells him that the patient doesn't have a wife – he's a widower.

House goes to Wilson about seeing a wife where none existed. Wilson tells House he may have imagined it and advises he rest, but House thinks he was hallucinating and that perhaps he can't trust his own judgment. House wonders why he got ketamine during his surgery.

House goes to see Cuddy about the ketamine. The ketamine would have put him in a coma. Cuddy admits that they did it on the chance that his chronic pain could have been treated by putting him in a coma. House is still afraid the ketamine might have affected his brain. He denies having any neurological symptoms, like hallucinations.

House goes back to talk about the swollen tongue patient with his team. Chase understands that House believes that the patient may have cancer spreading through the lymphatic system. The shooter wonders how Chase anticipated House, and that maybe House isn't as smart as he used to be. He points out that House is a rebel, but he runs with his own rule – that you have to be blunt and honest or else you're a coward. The shooter counters that being polite and having humility is not a bad thing.

The team comes in to see House. The test on the lymph nodes was negative. Chase is walking the patient to the washroom, where the patient's scrotum starts swelling with blood and bursts.

They can't figure out where the swollen tongue patient's scrotum blood came from. When House suggests the kidneys, Cameron points out that it's impossible – the kidney isn't connected to the scrotum. Foreman suggests testicular cancer.

House talks to Wilson about why he didn't think of testicular cancer and why he screwed up a basic anatomy problem. House thinks his brain is screwed up. Wilson suggests that House doesn't want a healthy leg, because then he would be happy. Wilson points out that persons incorrectly diagnosed with a terminal disease often get depressed when they are told they aren't sick.

House wonders why Wilson isn't more upset about the ketamine. He goes to Cuddy to confront her about the problems with his thought processes and starts trashing her office.

When Wilson tries to stop him, House responds by punching Wilson.

Wilson after House has punched him in the jaw.

Leaning against the door, Wilson looks at House and tells House that he's unbelievable. Wilson then states that even when House is out of his mind with anger and fear, he still couches it in logical terms before asking House if he's hallucinating.

"Yeah, I'm hallucinating!", House snaps.

"No, I mean right now, " Wilson says before he repeats, "Are you hallucinating?", only this time, it's Jack's voice that's saying the words, not Wilson himself.

In that moment, House realizes he's hallucinating and that he's back in intensive care with the shooter. House also discovers that he wet the bed.

The team comes in – the swollen tongue patient doesn't have testicular cancer. They start walking down the stairwell, and House wonders how they all got there.

House goes to Cuddy again to tell her he thinks he is losing his mind and having blackouts. He takes himself off the swollen tongue case. However, he then realizes that Cuddy knows about his last hallucination, and that he must still be having a hallucination. He finds himself back in intensive care again.

House is talking to the shooter about how he can tell what's real. The shooter discusses whether or not it makes a difference, but points out that his team would stop him if he were doing anything dangerous.

House goes back to discussing the swollen tongue patient with the team. They talk about their basic assumptions. House starts discussing exploratory surgery, but Chase is opposed because of the bleeding problem. They discuss robot surgery, which is far more accurate than a human surgeon.

They take the patient to the surgery suite. House uses it on Cameron and stops the knife just before it touches her face and navel, and cuts a button off her shirt. The patient is still not convinced, but House tells him he will die without it.

House goes back to intensive care. The shooter asks him if he cares if he lives or dies, and tells him that House only cares about things he can measure objectively. House finally realizes what the problem is – his team isn't trying to take him off the case or argue with him. They also have the same knowledge he does.

House goes to the surgical suite, where the patient is set up for surgery. Chase goes to stop House, but House was thinking of hurting the patient, and Chase couldn't have known that. House realizes that as long as his delusion makes sense, he will remain in it. He realizes he has to do something that doesn't make sense. He deliberately kills the patient. The patient lies there without vital signs, bleeding and House thinks he has got it wrong. Suddenly, a bullet drops out of the patient's hand and lands on the floor. House picks it up.

All of a sudden, House finds himself on a gurney listening to the emergency room personnel and Chase telling them where he had been shot while they work to keep him alive. He tells Cameron to tell Cuddy he wants ketamine before he passes out.

This is the only House episode where there is no explanation for the central disease. Subsequent symptoms – intracranial pressure, rupture of the scrotum – are hallucinations, but the cause of the swollen tongue is never explained. The man with the swollen tongue is not a figment of House's imagination, because he'd begun the story before he was shot by Moriarty. Although many things can cause a swollen tongue, the case is relatively simple by itself.

• The episode takes may cues from the film Jacob's Ladder, where a dying soldier in a coma experiences a dream where he believes he's awake and hallucinating in relation to his war time experiences.
• This is the first of only two episodes directed by series co-creator David Shore. The other one is the series finale, Everybody Dies. In addition, this episode is Shore's directional debut.
• The shooter, Jack Moriarty, is named after Sherlock Holmes' arch nemesis Professor Moriarty. However, although he is identified as "Moriarty" in both the credits and the promotional materials for the episode, his name is never used during the episode.
• House's nickname for the man with the swollen tongue, "Harpo", is a reference to Harpo Marx who would often exaggerate the size of his tongue by thickening it between the lips and puffing out his cheeks.
• House's hospital bracelet shows both a birth date (June 11, 1959 – Hugh Laurie's birth date) and his Social Security Number. A person with that number would have applied for it in the state of Ohio.
• Instead of using the term "dress" when talking to the person House thinks is the tongue patient's wife, the English Laurie uses the British "frock".
• Wilson talks about the situation where a misdiagnosed terminal patient is told they are going to live often results in depression. This very situation became a sub-plot in the episode Games.
• In the scene where House uses the robot surgeon on Cameron's blouse, it is reported that many of the crew were blushing from the intimacy inherent in the scene.
• The taco stand shown in some scenes is one of the best known in Los Angeles, "The Cactus", and is located on Vine Street north of Melrose Avenue.
• In the Sherlock episode "His Last Vow", Holmes also gets shot, has a series of hallucinations, and uses them to survive the experience.

Polite Dissent was willing to cut them some slack on the medical errors given it was all imaginary in any cases, so criticisms of the medicine should be taken with a bit of salt.

• A continuity error - When House is first seen on the ground after being shot, the marker he was holding is lying near his head. However, in the following shot, it's still in his left hand.
• In the scene where House tears his stitches, you can see the bag holding the fake blood falling on the floor next to him.
• The team won't give the patient a lumbar puncture because he has elevated ICP. However, the way elevated ICP is usually detected is by performing a lumbar puncture. How else would they know he had elevated ICP? Goof's goof You cannot do a LP with elevated ICP as this can cause a tonsillar hernia which is a life threating complication. Elevated ICP is usually suspected due to history and a CT head although it can be directly monitored with an intercranial probe.
• The best way to biopsy the lymph node below the jaw is to approach it from below, through the skin of the neck, not above through the mouth.
• The patient was put on antibiotics twice. If they didn't work the first time, it was unlikely they would work the second time.
• A patient who has had surgery to his stomach and small intestine would probably not be wise to eat a taco two days after surgery.
• It's almost impossible to damage the peripheral nervous system with abdominal surgery - it's one area of the body that doesn't have a lot of peripheral nerves. It certainly wouldn't affect House's leg. Goof's goof: The affection to House's leg comes not from the wound, but from the ketamine induced coma.
• Even assuming that a ketamine induced coma could cure chronic pain, there's no reason to use it as anesthesia. The surgery could have been done under normal anesthetic, and then they could have tried ketamine after House recovered. Goof's goof: House would never agree to use ketamine induced coma, therefore, they did it while he couldn't argue against it. [Goof's goof's goof: It is revealed at the end of the episode that House himself requested that Cuddy give him ketamine in the ER when he escapes his hallucinations]
• While discussing the cause of the rupture of the scrotum, Cameron states that "Kidneys drain into the bladder, which drains into the ureter". The correct human anatomy is that the ureters are the tubes that drain the kidneys into the bladder while the urethra is the tube to which the bladder drains.