Have you ever had a roommate who just wouldn’t shut up no matter how many times you asked? That’s Dr. Greg House’s (Hugh Laurie) problem (well, one of his problems) on the phenomenal sixth season of House, premiering Sept. 21 on Fox.

If you recall, House’s drug problems and hallucinations became increasingly severe and unmanageable at the end of Season 5, prompting our favorite narcissistic doctor to voluntarily check himself into a mental institution for help. The opening shot of the new season shows House’s hands and feet tied to a bed at the mental home, and he looks disoriented, distraught and completely out of it. In the scenes that follow, House tries to sign himself out of the facility, but the head doctor, Dr. Nolan (the always phenomenal Andre Braugher), encourages him to stay and get help. Nolan explains to House that his issues “run deeper than vicodin” and recommends a long-term stay for the good doctor, which really pisses House off. Rather than cooperate with Nolan, House decides to rebel against all of the doctors in the facility à la Jack Nicholson in One Flew Over the Cuckoo’s Nest. “I’m going to turn this ward upside down, making you and your boss’s life so unmanageable that he’ll write whatever he has to write to get rid of me,” he tells a nurse.

Obviously, House is having a really rough time in the Cuckoo’s Nest, and his situation becomes even more unmanageable when he meets his manic-depressive roommate, Alvie, played by former In the Heights star Lin-Manuel Miranda. Alvie is a high-strung, talkative, neurotic, proud boricua (he even has a Puerto Rican flag above his bed!) who randomly bursts into song and is incapable of silence. We get our first look at Miranda (who is brilliant, by the way) when he introduces himself to House in their new shared bedroom: “Nice to meet you. My roommate last time couldn’t stand me,” he says. With an overdose of sarcasm and a bit of eye rolling, House replies, “Really?” Like Miranda, Alvie is a performer who loves to freestyle and kick beats. “I don’t sing—I rap,” he tells House, adding, “I’m Juan Alvarez. That’s my stage name. But Alvie is what everybody around here calls me—like the Woody Allen character in Annie Hall, but the Puerto Rican version and not as neurotic.” He’s also a ladies' man who flirts during group therapy sessions: “It’s great to be back here in Mayfield. Not just for the food, not just for the ladies—well, okay, maybe just for the ladies!” Miranda’s Alvie is likeable and tons of fun.

When House needs to use the phone to make a call (and he can’t because only certain patients are allowed to make calls), he comes up with a plan that requires Alvie's help. He tells Alvie to allow him to beat him up so that he can be punished for his bad behavior and forced to take pills. He then tongues the pills and doesn't swallow them in order to trade them with another patient in exchange for phone privileges. The fight scene between Miranda and Laurie is hilarious, especially since House actually does want to beat the crazy out of Alvie. “You sure you’re good with this?” House asks him just before he punches Alvie in the eye, throws him to the floor and starts punching him repeatedly in the stomach and face. It’s also funny afterwards when a semi-grateful House tells Alvie, “Turns out you’re my only friend … and I hate you.” Ha! There’s also a funny scene where Miranda kicks some freestyle beats and rhymes on stage during a talent show with House's help. Here are some of the highlights of their dope collaboration:

“Welcome to Mayfield / Where the day feels long / We act strong / But there’s gotta be something wrong.”

“I am a manic Hispanic / I’m trying to make it work / But the doctors think I’m lazy / And my roommate is a jerk!”

If the sight of a grumpy doctor and a manic-depressive Puerto Rican chatterbox kicking flows on a stage in a mental hospital doesn't make you laugh—there’s something wrong with you.

All jokes aside, the House season premiere is also very touching. House and Alvie develop a bromance and hug it out like two bros on Entourage. Also, I won't say specifically how or why, but the most touching part of the two-hour episode comes when we see that House’s stay at Mayfield actually starts to have a major impact on Alvie’s life. Make sure you have your tissues handy when you sit down to watch this episode.