Jimmy Sidas delivers boxes to a small scientific bookstore. The storeowner recognizes him as a brilliant young scientist and asks him to sign a copy of his book. Jimmy is unable to write his own name.
House and Cuddy cross paths in the hospital cafeteria. He hopes for an invite to Cuddy's sister's house for Thanksgiving. She gives him Jimmy's file instead. The team discusses the case. Chase suggests TTP, so House orders tests for that.
Taub makes a comment about Jimmy's menial job, and Jimmy responds that he is a courier by choice because he does not have the burden of genius. He would rather be happy than smart. Foreman enters the doctor's lounge to find Chase lying on the couch, despondent. He tries to be supportive since Cameron left him.
Taub and Thirteen discuss returning to the team as they go through the test results. Thirteen finds Schistocytes in Jimmy's blood, indicating TTP. Jimmy has an albumin colloid allergy, so they cannot use plasmapherresis on him. They will have to remove his spleen.
House goes searching for Wilson because he wants to know where Cuddy's sister lives. House intends to break up Cuddy and Lucas on Thanksgiving. Meanwhile, Chase checks on the patient after the spleenectemy. Jimmy's words make no sense and Chase sees that he is having a stroke.
As he dials every Cuddy in the phone book looking for the sister, House asks the team what ailment could resemble TTP. Foreman suggests "Otis Campbell," which is the mnemonic for toxins. House orders an unstandard tox screen for the patient. Taub and Chase search Jimmy's apartment and discover a closet filled with scientific notebooks and a medicine cabinet filled with ordinary items like cough syrup. Then Chase spots a bottle of vodka hidden in a vent.
Cuddy notices that House is taking patients in the clinic. She invites him to her sister's home for Thanksgiving dinner. House triumphantly announces this to Wilson, who suggests that perhaps Cuddy gave him a fake address.
The team concludes that liver failure would explain all of Jimmy's symptoms. House assigns Taub and Thirteen to biopsy the liver. Jimmy denies being an alcoholic, and his wife is surprised to learn that he hid vodka. After the biopsy, Thirteen and Taub realize that Jimmy's kidneys are the problem. Renal failure can explain all the symptoms.
During Thanksgiving dinner, House pulls up to the home of Cuddy's sister. He knocks on the door and a woman answers. It is the house sitter. Cuddy's sister is out of town, and she was told to make Dr. House a turkey sandwich. House realizes that he has been duped. Cuddy is in her own home enjoying the meal with Lucas.
Lucas returns to his place to find House waiting there with a bottle of tequila. House drunkenly confesses his feelings for Cuddy.
Without House, the team tries to diagnose the patient. Taub suggests that a cough could mean Goodpasture Syndrome. Foreman calls for dialysis. Thirteen tries talking to Chase about Cameron but he rebuffs her.
Cuddy goes to Wilson's apartment demanding to know what House said to Lucas to make him break up with her. Cuddy insists that there is nothing between her and House. There never will be. House is pleased that he was able to break them up. He can't believe that Lucas fell for his "drunken" confession.
Jimmy is undergoing dialysis. House accuses him of having a cough syrup addiction known as "Robo tripping." Brain damage is tempered by a dose of daily alcohol. Jimmy has improved and his alertness has increased. He tells Foreman that this state makes him miserable. He snaps at his wife.
Jimmy can't feel his legs, and House becomes impatient with the team's inability to cure the patient. He pushes Chase to the point that Chase punches House in the face. House falls to the ground. House turns to Jimmy because, with his mind power, perhaps he can help figure out what is wrong with him. Jimmy tells House that he was in so much pain from his intelligence that he tried to kill himself by jumping off of a building twelve years ago. He broke bones, including three ribs. House hands Jimmy a bottle of cough syrup. He then asks Jimmy if ribs were broken on the left side. He pushes Jimmy's bed toward radiology. House tells the team that he wants an MRI because, in the fall, bits of Jimmy's spleen may have spread through his body. The image reveals that the spleen is in sixteen areas.
Chase follows House in the hall and explains that he hit him in order for the team to back off of him and his Cameron issues. House can respect this.
Jimmy is going to go back to numbing himself with cough syrup in order to be happy with his wife. House tells him to tell his brain goodbye. Taub catches up to House and snaps a picture of his bruised face. Taub brings the photo home to his wife and takes credit for the damage. He is out of the doghouse for now.
As a gesture of good will, House offers Cuddy two tickets to a petting zoo. She declines. House tells Wilson that he knows Cuddy and Lucas did not split up because she would not take the tickets. Cuddy comes home to Lucas and tells him that House knows she lied. They hope that he will now leave them alone.