In a flashback, a doctor explains to new parents that their baby has a condition called genetic mosaicism, where there is both male and female DNA present. The parents will have to choose which gender to raise their child. In present day, thirteen-year-old boy Jackson plays in his high school basketball game as his parents cheer him on. As his teammates congratulate Jackson for his winning basket, he winces in pain and drops to the floor.
As House and Wilson eat breakfast in cafeteria, House seems noticeably courteous. Cuddy approaches them with the case. The parents have not told Jackson about his condition and do not want the doctors to mention it as well. House brings the case to the team. Foreman suggests that the patient could be dehydrated, but Kutner notes that the ER gave him fluids when he arrived. Taub lists a number of possible intersex disorders. The parents recently started Jackson on testosterone, which they have dubbed "vitamins." Thirteen thinks a blind uterus hiding in his abdomen could be causing the pain. She says the kid needs an MRI, but House considers that a waste of time.
The parents come to the office to meet House, and express their belief that Jackson may have a blind uterus. House agrees to do the MRI rather than challenge the parents. As Thirteen and Taub perform the procedure, Taub asks her about Foreman. The test shows no sign of a blind uterus. Meanwhile, Kutner reports to Wilson that something must be wrong with House because he approved the MRI which he previously overruled.
Taub prepares the scope to fill Jackson's bladder with saline in order to examine his urethra for narrow spots. Jackson asks for his parents to be by his side. As Taub feeds the cystoscope, Jackson's heart begins to hurt. His heart is leaking exudate and they need to drain it to prevent it from stopping.
Back in House's office, the team considers the source of the pericardial leak. The testosterone could trigger autoimmune diseases, which would cause pericardial effusion and pelvic pain. House says to start Jackson on corticosteroids and finasteride to block the testosterone.
Wilson presses Cuddy about House's sudden good mood, and whether it is because she slept with him. Cuddy replies that, if she had, she would be "curled up in a ball, weeping in shame." Later, House enters an exam room in the clinic to find a stoner dude watching TV on his phone. Surprisingly, House gets along with him as he examines the guy's hand. Cuddy watches in disbelief as House and the patient leave the room as new buddies.
Thirteen asks the parents to sign a consent form, but they refuse to tell Jackson the truth about his gender. Later, she discusses basketball with Jackson, who admits that he is more interested in dance. Thirteen notes that the boy's hands are red. Meanwhile, Kutner jokes with Foreman that Thirteen's bisexuality would have been a problem had they continued their relationship.
Cuddy tells Wilson that he was right about his observation of House. They go to House's office and try to wake him from his nap. The team moves quickly when House is unresponsive. Foreman twists one of House's nipples to bring him back, and it works. Wilson and the team look on as Cuddy examines House, who claims to be fine. Thirteen informs him that Jackson has red palms, consistent with liver and kidney dysfunction. Thirteen suggests that the teen may have been self-medicating. House wants them to search the school and home. Wilson pulls Cuddy aside to tell her that House is on heroin because it is stronger than Vicodin.
As Thirteen and Foreman search Jackson's room, he asks her if she misses sleeping with women. They consider that Taub and Kutner know that they are still secretly dating. Thirteen finds a paper in the desk, which is an angst-filled poem that she believes is a cry for help. Thirteen shows the poem to Jackson's shocked parents and urges them to tell their son the truth about his genes.
Kutner and Taub finalize their bet that Foreman and Thirteen are still together, and Taub hands Kutner ten dollars. Foreman realizes that House still doesn't know, and calls Wilson to tell him that House is on heroin. Wilson is actually out with House as the call comes in. The waitress brings Wilson a beer and House a shot. Although House does not want to drink it, he downs it and leaves. Wilson finds House is in an alley, vomiting. Wilson accuses him of taking heroin, but House confesses that he is really on methadone. Wilson chastises House for nearly dying. Yet House walk away, pain-free in his leg.
With Jackson hooked up to an IV of antibiotics, Thirteen administers a shot. She tells him that it is not "vitamins," but cannot divulge that it really is testosterone. Jackson's parents complain to Cuddy about Thirteen, but Cuddy defends her. They are forced to try to explain Jackson's condition to him. He becomes angry.
Cuddy bans House from taking methadone in the hospital. He threatens to quit.
Jackson stares out the window as Thirteen hangs a new bag of antibiotics. She had mistaken his English assignment for a suicide note. Suddenly, Jackson heaves up bloody vomit. House hears his pager as he is preparing to shave. He tosses the pager in the trash.
Taub, Kutner and Thirteen wait outside Cuddy's office as Foreman emerges. They wonder if House quit or was suspended. Foreman is now in charge. Thirteen reports that the surgeon found that a gastric fistula caused Jackson's bleeding from a necrotizing pancreatitis. Thirteen diagnoses Zollinger-Ellison but Taub suggests system scleroderma. Foreman decides to put the patient on proton pump inhibitors. If he gets better, then the cause is Zollinger-Ellison. If not, then it is scleroderma.
Foreman comforts Thirteen, who feels guilty about causing Jackson's family to be at odds.
Wilson comes to House's apartment and passes a young woman on her way out. House claims that he hired the woman to watch him sleep. He is clean-shaven and professionally dressed. Wilson later tells Cuddy that they made a mistake about House -- he is doing well.
With Jackson not responding to the medicine for Zollinger's, his parents lash out at Thirteen. Foreman tells her that the boy's AST level dropped a little, which is positive news. Kidneys damaged by scleroderma would not respond to the medicine. Jackson must not have it.
House comes to Cuddy for a letter of recommendation. She offers him his job back if he follows a regimen of methadone on a precise schedule. House returns to his office where the team is waiting. They update him on the diagnosis. House realizes that the patient probably consumed special energy sports drinks, and the patient confirms this. The drinks put a strain on Jackson's kidneys, which needed more time to normalize from dehydration. However, when the parents demanded the MRI, the test's contrast dye affected the organs. House blames the parent's overprotective behavior for nearly killing their son.
Jackson recovers, and tells Thirteen that he plans to play basketball and take dance lessons.
Cuddy brings House his medicine, but House says he is finished with it. Being nice threw him off of his game.