As emergency workers struggle to douse a raging blaze, a firefighter named Derek Hoyt walks out of the burning building intact. Suddenly, he gasps for air and becomes delirious. When he staggers back towards the building, he complains of being freezing.
Cameron examines Derek, who is covered in skin grafts. His last procedure was six months ago. His body temperature is wildly swinging up and down. She wants to refer him to House, who is currently at a preliminary hearing pleading not guilty to all charges. The judge sets an evidence hearing for a later date.
Back at the hospital, House gets the details on Derek's case. Thinking of the skin grafts, Chase suggests a hospital-acquired infection. House orders a blood culture and a round of antibiotics. Cuddy summons House to her office and orders him to talk to Tritter. She blames the entire situation on House. Tritter kept setting traps for him, and House continually fell into them. House actually seems somewhat chastened.
Cameron visits Derek and explains they think he has Mercer Disease, a common bacterial infection contracted in the hospital. Derek asks if Mercer makes everything look blue. Cameron immediately realizes that it's something else entirely. House suggests male menopause or really high estrogen and low testosterone levels. He instructs his team to run a hormone panel.
The doctors attempt to draw blood from Derek, but when they get the needles into his arms, he freaks out and demands that they be removed. He grabs Cameron and begins choking her as Foreman tries to restrain him. Foreman injects a sedative and Derek goes limp.
A very contrite House pays a visit to Tritter. He admits that he can be described as anything from arrogant to unhinged, but he has to act that way because of the constant, crushing pain he deals with. His pain can be described as intolerable only on a good day. He knows that he has handled it incorrectly. Tritter thanks him, but is sure that House didn't mean a word of it. Tritter says he will see him at the hearing.
Back at the hospital, the team updates House on Derek's case. They insist it has to be neurological. Foreman wants a CT for a frontal lobe tumor and an LP for meningitis. An absent House agrees and leaves. The team chases after him, wondering why he isn't shooting down their ideas. He says it is because he has to go upstairs and check himself into rehab.
Without House, the team starts their first differential diagnosis. Cameron immediately wants to consult House, but Foreman and Chase think this is their chance to grow up. And with House undergoing detox, he won't be much help. Chase recalls an old House comment: "Everybody lies." With all of the skin grafts Derek has had, he must be in tremendous pain. He must be hiding his pain to keep his job. They need to find the pain. Suddenly they are paged. Derek cannot breathe.
Chase quickly recognizes a heart attack and they stabilize him, but realizes it won't last long. Derek has been hiding a series of chest pains. Now they have to figure out what's causing these attacks. Cameron goes to see House and finds him puking in his rehab dorm room. House advises them to look for an external or environmental cause that all three attacks share in common.
After some thought, the doctors summon Derek's firefighting partner, Amy. Derek then suffers another attack. The doctors perform a battery of tests on Amy, who's clean of any spores, molds, toxins or possible physical causes. Cameron asks Derek if he's in love with Amy. He is unable to admit to it because Amy is engaged to his brother.
The team reports back to House to figure out a plan. When they theorizes that the only way to cure Derek is to end his love for Amy, House has a radical solution. They can fry his brain to clear any thoughts of Amy. A procedure like that will need Cuddy's permission, and the doctors are actually able to talk her into it.
Cameron explains the planned procedure to Derek. This electroshock therapy will wipe out Derek's memory. His feelings for Amy, his firefighter training and his childhood. Cameron begs Derek to tell Amy how he feels. If not, he's choosing to wipe out his entire life for a secret.
Tritter pays a visit to House in rehab because Cuddy goaded him into it. He's still not going to talk to the DA. House rails that Tritter's word means nothing. Tritter says he'll never trust an addict, and even House's actions lie.
The doctors perform the procedure on Derek and then test his mental faculties. They bring Amy and his brother in. Derek has no memory of either of them. The team informs House that everything has basically worked out. Later, Cameron and Amy observe Derek through a window. Cameron congratulates Amy on her upcoming wedding, but Amy has no idea what Cameron is talking about. She's not marrying Derek's brother nor do they even date.
The doctors place an emergency call to House, who's at his evidence hearing. Derek's memories were false. They fried his brain for nothing and whatever was plaguing him is still there. They talk through the symptoms and House orders his team to set up Derek with a selective vertebral angiography. As House limps out of court, the judge threatens to find him in contempt. He leaves anyway.
House has realized that all of Derek's issues go back to the initial thoughts on menopause. The test reveals spinal meningioma pressing on an artery and affecting Derek's brain. They need to schedule surgery to remove it.
At the trial, Cuddy is on the stand when House barges back in. The DA shows Cuddy the pharmacy log and asks if this indicates that House stole oxycodone from Wilson's dead patient. Cuddy explains that it does not. The DA states that Cuddy testified earlier that it did, but she presses on. Dr. Wilson informed her that House had tried to steal the same patient's oxycodone before, so Cuddy went down to the pharmacy and swapped out bottles. House stole a placebo. She has a pharmacy inventory report reflecting her order. Tritter vehemently protests that this report is obviously forged. The judge asks why Cuddy didn't come forward with this evidence earlier. Cuddy admits that she never thought it would come to this point. The judge, while making a point to chide House, declares that Tritter tried to make an example out of House and dismisses the case based on both Cuddy's testimony and her efforts to protect House. However, House is still guilty of contempt for walking out earlier, so it's a night in jail for him.
As the bailiff leads House out, Tritter stops him. House bristles for a threat, but Tritter merely wishes him luck and says he hopes he's been wrong about him.
At the hospital, Cameron explains to Derek that this latest treatment has worked. He can move on and begin creating new memories.
That night, Cuddy and Wilson visit House in jail. Cuddy is angry that House forced her to forge evidence and perjure herself. She makes it clear that she owns him now. It may entail clinic duty, unruly patients or extra hours. Whatever she wants, he's going to do it. She walks off. Wilson slips House a cup of medication from the rehab supervisor. House greedily gulps it down. Wilson realizes that the rehab supervisor has been slipping House Vicodin. House smiles, proud of his scheme. Wilson, distraught and despondent, worries that nothing has changed.