A forty-something man, Bert, is hard at work cleaning a blood-soaked apartment. As he's scrubbing the floor with a brush on his hands and knees, his cell phone rings. Bert carefully peels off his filthy gloves to answer it. "Hey, sweetie," he tells his wife. "Yeah, sorry, the meeting's running a little late. Well, you know Matheson - guy loves to hear himself talk. Yeah, I'll meet you at the restaurant. Hey, we're going over the contracts now - I've got to get back in there." Bert tells her he loves her and hangs up, glaring at himself in a mirror in the room. Just then a policeman slides in with a cup of coffee in one hand and tells Bert to get back to work.
"I used to think my job sucked," the officer says. "How much do you make an hour anyway?" Bert tells him it's not enough - but unlike the cop, this is just a temporary setback. "You, on the other hand, will always be a schmuck," Bert says. "Yeah, a schmuck with a guaranteed pension and benefits. I'll take it," the cop answers, and leaves Bert to his gruesome work.
Later, Bert is cleaned up and wearing a business suit to meet his wife at a Japanese restaurant. "No talking about real estate tonight," his wife, Diane, says. "I really want you to just enjoy yourself." When the waiter brings by the appetizer, still moving on the plate, Diane says there's no way they can eat that, but Bert gamely take a big bite. "Actually, it's not that bad." He picks up his wine glass. "To us, on our third anniversary. The day I met you was . . . was . . ." But suddenly Bert looks ill. "Honey, what's wrong?" Diane asks. Bert struggles to breathe and his hand is covered in a rash. "Someone, please call 911!" Diane yells as she tries to help him.
House is busy hiding from Cuddy in the hospital, but she catches up with him in an elevator. "I assume you're avoiding me because of the charity gala," she says. It's true House doesn't want to go, even though Cuddy is getting an award, but he tells her he'll be there.
House brings Bert's case to the team in his office, interrupting a spat between Foreman and Taub about Taub's unauthorized use of Foreman's tie. "Tell me how someone can have an allergic reaction when all of their tests were negative for known allergies?" Chase immediately guesses an environmental reaction: Bert works in real estate, so maybe he was exposed to something at a construction site. But Masters thinks Bert is lying. "He's not an executive. I saw his hands. They're covered with calluses and little cuts. He works with them, a lot."
House loves that Masters was able to see through Bert's lie. "So what did Mr. Meathooks say when you called him a liar?" he asks. When Masters says that she didn't confront Bert on it, House tells her to go do it now. "But what if I'm wrong? I'll just end up offending him," she asks. "Consider that part a bonus," House says. She still doesn't want to go, so House tells her to take one of the male team members as back-up. "You want Scary, Smarmy, or Shorty?"
She picks Chase, and the two of them go to Bert's room to ask him some questions. Masters tries to gently usher Diane out, but she's not taking the hint. "Uh, they tend to be personal in nature, uh . . ." Diane says that she's his wife and she can probably answer Masters' questions better than Bert can. "They're about his job," Masters says. Now Bert perks up. "Honey," he tells Diane. "Take a break, it's okay." But she still won't leave. Chase steps in. "Our questions are about what he eats for lunch at work, and what comes out at the end. Bowel movements, mostly. Color, texture . . . smell . . ." That did it. "Maybe I could use a break," Diane says, as she walks out of the room.
Bert tells them his story and makes them swear not to tell Diane. "I lost everything because of the recession. My entire real estate company. And she has no idea. I used to be a janitor in college. Now I'm almost forty and doing it for the people I built homes for." Masters wants to know why he would lie to his wife about it, but Chase waves her off. "None of our business, really." Bert says that he does industrial jobs, crime scene clean-up, septic tank repairs, mold removal. Masters and Chase look at each other.
"It's the Holy Grail of potential diseases," she tells House, when they're back in his office. "Caustic cleaning chemicals, raw sewage, mold spores, fungal infection." And, Chase reminds her, he was cleaning up blood and body fluids from a homicide yesterday. Foreman says that they should check out the place themselves. "He might have picked up a bacterial infection from the victim's blood." But Chase says Bert's already cleaned it up. They'll try to get an autopsy report on the victim, but it might take a while.
"When he's not working, where does he go all day to hide out?" House asks. Masters says that he just goes to his old real estate office. House tells Chase and Masters to treat for bacterial infection, and assigns "Bert and Ernie" (Foreman and Taub) to check out his office. "I'll talk to Cuddy about getting the autopsy results faster," House says.
House bumps into Wilson in the hall on his way to see Cuddy. Wilson can't believe he's actually going to the charity gala. "I want to do something nice for my girlfriend," House says. "You never do anything nice unless it stands to benefit you," Wilson tells him. "I realize three failed marriages can leave a man twisted and bitter inside. But in a good relationship, people sometimes do things for each other," House says, and continues to walk away. Wilson calls out to him. "A hundred says you don't show up." Why is he giving House an incentive to show up? Wilson says he's just making easy money, and ups it to two hundred. Then House puts it together. "How high did Cuddy authorize you to go?" he asks Wilson, who stammers a bit before telling House he could have gone as high as three hundred. "She really wants you there!" "Why do people believe I'm incapable of doing anything nice?" House asks. "Experience!" Wilson yells.
"It's a tie. I'm not wearing your underwear." Taub and Foreman are at Bert's old real estate office, still bickering about the tie. Taub offers to give it back but Foreman tells him to keep it. "It went out of style five years ago." Poking around the empty, deserted offices, Foreman finds a bottle of Vicodin, with no prescription. "We didn't test for an allergic reaction to narcotics," Foreman yells to Taub. But Taub's found another possibility in a different corner of the office: the cleaning supply closet, with chemicals everywhere.
"We think you're suffering from boric acid exposure," Chase tells Bert, back at the hospital. Masters says that they'll need to decontaminate his skin; hopefully he didn't get any into his lungs. Suddenly Bert starts hyperventilating. "I . . . feel like . . . I'm . . ." and passes out. Chase looks at the monitor for Bert's vitals. "I've never seen a fever spike this fast before." Diane rushes in. "What's happening to him?!" Masters says they have to get the fever down immediately. "If it gets any higher it could cause permanent brain damage."
Back in House's office, Chase says that they used cooling blankets to get the fever down. He's stabilized, but there was no trace of boric acid. House has been reviewing the murder victim's autopsy report, which was negative for communicable disease. Taub mentions the Vicodin they found. "Give it to me," House says. The team members look at each other. "Might look like Vicodin but be something else," House explains. Foreman tosses him the bottle and they all watch him . . . almost take it. "It's real. Unfortunately. Because Vicodin doesn't cause rash, fever, and joint pain. It does make Taub considerably less annoying, though."
Foreman thinks maybe they're thinking too far outside the box. "Taub's life partner has a point. We started treatment with antibiotics and he got worse. Simple answer begins with 'm' and ends with 'mia.' " Chase correctly guesses meningococcemia. "Confirm with a lumbar puncture. And on the off-chance we're wrong, find out what else he's been lying about, besides his job and his drug use," House says.
Masters subtly begins the interrogation in Bert's room. "You sure do hide a lot from your wife. Your job, your drug use, what else?" Bert doesn't see why it would matter, but Chase tells him they can't help him unless he's completely honest with them. "I've been doing manual labor," Bert says. "If I came home, barely able to move, Diane would know something was up. So I take the Vicodin. To hide the pain. But I'm not an addict." He has been hiding something else, though. "I didn't just lose my job. I mean, that's how it started, but I figured it'd just last a couple of months. I maxed out our credit cards, took a double-mortgage on the house, and I sold all of our investments. Who'd have thought the recession would last this long, huh?" Masters can't believe he's trying to put the blame for all his troubles on the economy.
"Need some intel on this charity event on Friday night," House asks Wilson later that night in Wilson's office. "If I go, do I have to actually give money to charity?" Wilson urges him to just show up and behave, but House thinks that Cuddy deserves more than a plaque and some applause for all her work. "It's a watch, not a plaque," Wilson says. "It's a clichÃ©. I want to make things more exciting. Something she'll remember for more than ten minutes," House says. "OK, by fun and exciting you mean screwing this up for Cuddy so she won't even dream of asking you to go to one again?" Wilson asks. House feigns offense. "You really can't stand seeing me happy, can you?"
Masters, Taub, Chase, and Foreman are in the lab. "Gram stains are negative in the first CSF samples," Masters says. Taub asks Foreman if he wants to get something to eat afterward, but Foreman says he's busy. "Date?" Taub asks. "What difference does it make? We're roommates, not a married couple. We don't have to eat every night together," Foreman says. Masters says she's free that evening. "Ooh, shocking," Chase says. "Are you mad because I picked you? You're stuck actually doing your job?" Masters asks. "A little hazing never hurt a med student," Chase tells her. "I doubt it ever helped, either," she says. "I'm sorry that I think our patient shouldn't be lying to his wife. But I'm a woman. I guess I just have a different perspective." Chase says it's hardly an insight that women hate lying. But Masters says that her insight is really more about Chase. "You don't respect women. You sleep with a different one every few days. Or maybe you find meaning in meaningless relationships." Chase tells her at least he has relationships, but Foreman interrupts the mocking to say he's seeing a high lymphocyte count in the CSF samples. It's not meningococcemia. Just then all their pagers beep.
"He's getting worse!" Diane says, in Bert's room. "He can barely move his legs!" And he's lost feeling in his feet. "What is it?" Diane asks. "What is happening to him?"
House and the team discuss Bert while walking in the hall. They restored circulation to his feet before any serious damage was done. Foreman thinks it might be a viral infection. "Serum sickness fits everything," Masters says. "In rare cases, a tick or a spider bite could set it off . . ." House interrupts to ask who's going to the charity event on Friday. "Cuddy's getting an award. I think we should all be there, show our support." "I assume you're planning on screwing it up so you want to maximize the witnesses," Foreman says. "Why does everyone go to that?" House asks. "Experience," Foreman tells him. House tells them that they'd all better go or they'll be on clinic duty all weekend. "I hear it's Genital Herpes Awareness Month." Agreeing with Masters' idea about serum sickness, House says to take Bert off the antibiotics and put him on corticosteroids.
Taub catches up with Foreman in the doctors' locker room. "Canceled date, huh?" Taub sees that Foreman isn't putting on his "first date shirt." "You're tracking my wardrobe?" Foreman asks. "I'm just observant. It's why I'm good at my job," Taub says. "It's also the reason why you're starting to annoy the crap out of me," Foreman tells him. Taub says he was just trying to connect with Foreman. "I just found out that Rachel is now officially more than just emotional with her online friend." Foreman says he should have expected that, since they're getting divorced. "I know, you're right. Just thinking about it kinda makes me want to throw up." Foreman gives in and asks if he still wants to get something to eat. "I could cook," Taub says.
Later that night they're playing video games on the couch in Foreman's apartment, but Foreman is suspicious of Taub's poor skills. "Are you just letting me win?" Taub admits he was. "You're having fun, right?" he asks Foreman. "Not anymore," Foreman says, and puts down his game controller. "I used to think the whole brooding thing was part of your work persona, but now I live with you - you need to lighten up, Bert," he tells Foreman. Foreman says he isn't going to take advice on how to live from Taub - he's broke, he ruined his marriage, and yet he still acts like he's the victim. "Like, somehow we're all supposed to feel sorry for you. You screwed up your life! Not some emotional friend your wife met on the . . ."
But suddenly Foreman doubles over with pain in his stomach. "You - you poisoned me!" And he runs to the bathroom. Taub says he ate the same thing Foreman did. "How come I'm not . . ." But then he, too, falls over in pain.
Back at the hospital, Bert's locked himself in the bathroom. "Open the door, Bert!" Chase yells from the other side. But Bert is freaking out, seeing flashing lights and blood pouring from the sink, and his eyes are red. And the room seems like it's shrinking. "I can't get out! Why can't I get out!"
In House's office the next day, Masters says Bert's rash is gone, but whatever was causing it moved to his brain, evidenced by his psychotic break. Meanwhile, Foreman and Taub are looking sweaty and uncomfortable, but Foreman manages to say that since the hallucinations stopped when the steroids they gave him cleared his system, it might not mean Bert's problem has neurological involvement. "I think that . . ." But Foreman can hardly get a sentence out without wincing and gripping his side. Chase asks him what's the matter.
"Taub tried to kill me last night." Chase adds the bilateral conjunctivitis to Bert's list of symptoms. Soon Foreman and Taub both race from the office to the bathroom . . . with House, Chase, and Masters behind them. Soon they're all in the men's room. "Swollen joints, high white count, fever, conjunctivitis - anyone?" House asks, while Chase and Masters hold their noses. From behind the stalls, Foreman and Taub ask, "Seriously?" "What - you two can't think and poop at the same time?" House asks. Taub, with his pants around his ankles, suggests familial Mediterranean fever. Foreman says it's not likely. "That almost always presents with abdominal pain or diarrhea." Chase says with Bert's job, plus the skin and eye involvement, means it's probably a systemic fungal infection.
Between gagging, Masters says that they would have seen that in his blood work, unless there was a problem with the saline used to recover and store the tissue samples. "Get new blood and CSF samples using formaldehyde instead of saline," House says. "And start him and his wife on triple antifungal therapy." Masters asks why they're treating the wife as well. "If he's really trying to keep her happy, I assume they shared bodily fluids," he says. And House, Chase and Masters leave Foreman and Taub in agony in the bathroom. "I hate you," Foreman tells Taub, who just groans in response.
In Bert's room, Masters is setting up the IV bags for treatment. "You could have picked it up from your job," she tells him. "The real one, not the fake one. If you'd been more honest . . ." But Chase cuts her off. "How's that relevant?" Masters says that if both of them knew about his job they might have been more alert to the early symptoms, which Chase says is ridiculous. Diane walks in, with dark shades on - she's got conjunctivitis now, too. "Whatever you're doing, it's obviously not working," she tells Masters and Chase.
Chase explains their theory about the fungal infection, which can be transferred through bodily fluids. "A fungus?" Diane is confused. "Where would he -" Before she can finish, Chase says that he could have picked it up anywhere, as the spores can become airborne. But Diane doesn't know why only Bert got sick - and no one else in their neighborhood, and no one else in his office building. Chase keeps trying. "Sometimes it just . . . happens that way. It's hard to explain." Masters looks at Bert, who says, "No, it's not. I need to talk to my wife in private for a moment." Masters smiles at Chase and they leave the room.
It's late in the evening, and Wilson is wrapping up with a patient in his office, when suddenly he hears Mariachi music blasting. Not too surprisingly, he traces it to House's office, where he finds House and a live band. "What are you doing?" Wilson asks. "What does it look like I'm doing - I'm auditioning a band for Friday night." Wilson asks if his plan is to ruin Cuddy's night, but he denies it. "This is not a prank. These guys are the beginning of Cuddy's evening to remember," House says. "I think," Wilson says, "if you do this, your evening will end with you alone, in your apartment, with a sock." But House just strikes up the band again.
Masters and Chase are at the nurses' station, watching Bert talk to Diane. "This is all for the best," Masters says. "Yeah," Chase answers. "Either that, or the opposite." When Diane walks by, clearly distraught, Masters tells her that Bert was really just trying to protect her. Diane looks at the two of them. "Oh, of course he would tell a bunch of strangers before he would tell me! I mean, why not? I'm just a stupid housewife, right? You know, I have something you can share with him: it's over. He's a liar and I never want to hear from him again! You may want to go check on him; his fever's back. But I am done worrying about him." She walks away, and Masters is stunned. She and Chase race in to check on Bert. They try to tell him they're going to help get his fever down - but he can't hear them. "Why can't I hear anything?!"
House and the team are reviewing Bert's condition in the hallway. Bert's hearing is almost completely gone, and the new CSF tests were negative for spores and fungus. Chase says tumor necrosis factor syndrome fits the conjunctivitis and the joint pain, but Masters pointedly says it's never been documented to cause hearing loss. "This isn't the classroom. In the real world, real doctors know that patients can have more than one thing wrong with them. He was taking Vicodin. Extreme abusers can experience hearing loss." Foreman thinks it's probably neurological. Possibly a brain tumor or a viral infection that's reached his brain. House agrees with "Ernie" and orders an MRI for the patient. Before they leave, Taub tells Foreman he's going to move out. "I'd rather stay friends than be roommates." Foreman tells him to make sure to gives him his keys back and starts to walk away. Taub calls after him. "It's not my fault! I cooked it thoroughly!"
"Looking forward to Friday night?" Wilson and Cuddy are sitting in the cafeteria. "Yes, and no," Cuddy says. "Yes, because it is a great honor, and no because . . . well, you know the because." Is she worried that House is going to embarrass her? "Well, not intentionally. Maybe intentionally," she admits. "I know what you mean," Wilson says. "I picture him doing something stupid, like . . . hiring a Mariachi band or something." He checks for her reaction, but Cuddy says, "Well, actually, I could get behind that. I tried to hire one last year, but the Board wouldn't let me because they thought it was too expensive." So House was doing something nice after all. Now Wilson doesn't know what to say.
Chase and Masters are prepping Bert for his MRI. He's freezing, and he wants to know if Diane is coming back. They haven't told him yet what she said to them. On a piece of paper, Masters begins to write "No" for Bert to see, but Chase stops her, so she changes it to read "Not yet." They slide him in the machine and walk out to the observation room. "Bedside 101: when a patient is near death, try to be nice," Chase admonishes Masters. But Masters says she won't lie to Bert. They can't continue their argument as Bert is seizing in the MRI machine. They race in to save him.
Later, House and the team talk outside Bert's room. Bert's now on dialysis because his kidneys are destroyed and he's in a coma. Taub says he only has a few days left to live. Chase says getting him on the transplant list is unlikely, given his condition and the fact that they don't even have a diagnosis. "He wouldn't survive the surgery," Masters says. "Hence my previous comment," Chase fires back, annoyed. So what should they do? "What if it's a tumor, and we start chemo? Bombard his head with radiation," House says. Foreman says that would likely kill him in the condition, plus they never completed the MRI, so they don't even know if he does have a tumor. "He's definitely dead if we do nothing," House says. "If I'm wrong, all we do is shave a few hours off." And he wants Masters to get the necessary approval from Bert's wife. "Probably not a good idea," Chase says, and Masters says he's right. "No, he's not. Consider this officially me booting you out of the nest," House tells her.
Masters is waiting for Diane in the lobby when Chase walks by. "Just wanted to watch," he says. "Do you even like me?" she asks Chase. He's caught off-guard. "Why?" "I put making friends and having relationships on hold so I could concentrate on studying. I always thought there'd be plenty of time for that in the future. But, now, when I do want them . . . I can't even get a date to this charity event. If I can't establish relationships in my personal life, how will I ever do it with a patient?" Chase doesn't have an answer, but just then Diane shows up, and he does have some advice on that end: "Be honest with her. But if it comes down to a choice between the brutal truth and hope, start with hope." Masters walks over to Diane and tells her Bert's in a coma. "We think it's a brain tumor and we need your permission to start treatment. Due to his current condition, the risk factor . . ." Diane interrupts her. "You mean, it could kill him?" "It's possible," Masters says. "But there is still hope. You need to hold on to that." She's trying her best but she's not too reassuring. Diane insists on seeing Bert, even though Masters advises against it. "Look, the last thing that I said to him was 'I hate you.' I have to tell him the truth. I have to see him, please. Can he hear me? They say that people in comas can still do that." Masters says, "Sometimes, but your husband's hearing . . ." She can see Diane is distraught. ". . . is fine," she lies. Masters looks at Chase and he nods his head in approval.
Masters is watching at the door of Bert's room as Diane talks to him. "I didn't mean any of those awful things I said. I'm so sorry. I love you, Bert. I've always loved you. I also kept a secret from you. I was going to tell you at the restaurant, but you got sick. And I wanted to wait until you got better." She starts to cry. "I'm pregnant, sweetheart. You're going to be a daddy." Diane leans in and takes Bert's hand. As she does, Masters notices Bert's rash spreading up his cheek.
Back in House's office, they're reviewing Bert's symptoms, which now, again, include a rash. "It went away. It needs a reason to come back. We know it's not an allergic reaction, so we must have done something to set it off again. What?" House challenges them. The dialysis? Moving him to the ICU? The partial MRI? Chase says that was two hours before the rash broke out, so it can't be connected. House asks what he was doing two hours before the first rash broke out. "Cleaning a crime scene," Foreman says. "Crime scene and an MRI. Still not seeing the connection," Chase says. House asks if he said anything when he was in the MRI room, and Masters mentions that he was cold.
"Cold and rash," House says, as he ruminates on an idea. "That's what we did. We made him cold. CAPS, a genetic disorder caused by a mutation in the cold-induced auto-inflammatory syndrome 1 gene." Foreman is skeptical. "Muckle-Wells syndrome? There's only been a couple thousand documented cases in the US." House says it fits every symptom. "Treat with rilonacept. He'll live a long and healthy life, filled with lies to his wife and future child."
But as Chase and Masters walk back to Bert's room, they can hear emergency alarms from his equipment. They race in, but they can't revive him.
Later, House is sitting in his dark office, alone, and Wilson comes in. "You OK?" he asks. "Why wouldn't I be? I solved my case," House says. "But your patient died," Wilson says. "I didn't say in time," House tells him. But Wilson's actually there to apologize. "You're right. I am turning bitter and cynical inside," he tells House. "Go home and change. Party's in a few hours," Wilson says, as he leaves House's office.
Taub and Foreman are changing into their tuxes in the doctors' locker room. "You don't have to move out, if you don't want to," Foreman tells Taub. "You asking me to stay?" Taub asks. "No," Foreman tells him, "but I realize you might have had a point. I've been alone a long time. And I don't want to end up like House."
All dressed up, Masters and Chase wait for Foreman and Taub, their ride to the event. "You're not picking up your date?" Masters asks Chase. "Nah, going solo. All those meaningless relationships tend to wear a guy out after a while." Foreman says that they've got 15 minutes to get there if they want to see the Board freak out when House's Mariachi band marches in.
But House isn't there to see it. He's sitting alone at a bar, ignoring his cell phone and rubbing his temples. Wilson walks in and sits next to him. "All of them are gone, Wilson. They're all dead because I'm screwed up." Wilson doesn't understand - he lost one patient? And it wasn't his fault. "How about that mom who gave her baby cancer? If I'd figured that one out quicker she'd still be a mom, alive. And there's that guy I spent a day trapped in isolation with. I was five feet away the whole time. I just watched him die like an idiot."
"Yeah," Wilson says. "You've lost patients before, and you'll lose patients again. Why is that -" House interrupts him. "Exactly, why? Because love and happiness are . . . nothing but distractions. The only thing my relationship with Cuddy has done for me is make me a worse doctor." Wilson laughs. "Oh, the Great Dr. House doesn't deserve to be happy? You know that's not true."
"My happiness is being paid for with other people's lives," House says. He asks about Cuddy. "She's worried. Upset that you didn't show up tonight. She wanted to come look for you, but I wouldn't let her. Tonight's supposed to be about her." House grabs his keys to leave. "I've got to tell her the truth," he says. But Wilson takes the keys from him. "First, you're not driving anywhere. And second, you are definitely not talking to Cuddy like this." So House just walks away.
He shows up at Cuddy's door later, soaking wet from the rain. "We really, really need to talk," he says, and walks in past her. "You're drunk. And you screwed up big time. Go home!" Cuddy says. But he's already in the living room. "You're going to want to sit down for this," he tells her. He gathers himself and says, "I have made a decision. Being happy and being in love with you makes me a crappy doctor."
Cuddy tells him to shut up. "You're too drunk to end this relationship." "I am drunk," he says. "But I'm also right. You have made me a worse doctor. And people are going to die because of that. And, you . . . are totally worth it. If I had to choose between saving everyone and loving you and being happy, I'd choose you."
Cuddy doesn't know what to say, as House lays his head in her lap. "I will always choose you," he says. He laughs. "My head's on your vagina." "Go to sleep, House," Cuddy tells him.