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A death-row inmate is on death row when his cellmate Clarence is taken to an exercise room. After going through an exercise routine, Clarence hallucinates the people he’s killed and panics, then collapses from some kind of heart problem.

House goes to visit Cuddy, who is visiting with Stacy. After talking his way past Cuddy’s new (male) secretary, House convinces Cuddy to give him Clarence’s case. House leaves Cameron to fill in for him at the clinic and gets in to see Clarence, a dangerous prisoner. Clarence is suffering from lack of oxygen and when the warden is reluctant to have him removed, House has Stacy get him moved with a court order and they close off a hospital floor to do so. Cameron’s clinic patient, Cindy, has lung cancer but Cameron suspects it’s something else and House believes she’s reluctant to accept the patient is dying.

Foreman suspects Clarence is using heroin and none of the staff are too sympathetic toward the death row prisoner. When they check him out he goes into a seizure and complains about thirst. House orders more tests and then Stacy confronts him, feeling House is abusing her trust. Clarence confronts Foreman over his gang tattoo and it becomes clear Clarence isn’t a particularly nice guy. The blood gas shows a new symptom, and overall it points to tuberculosis. House sends Chase to the prison while Wilson meets with House and suggests he get Stacy’s trust back, but they’re interrupted when Clarence goes into a coma. House gives him a short-term boost and calls Chase back when he finds nothing. While Cameron hedges on telling Cindy about her lung cancer, House goes to Clarence and they get drunk together. Over their bonding House reveals he knows Clarence tried to kill himself by drinking copier fluid and the alcohol he’s been drinking neutralizes it

The next morning House (with a hangover) staggers in – Stacy confronts him and he admits he thinks Clarence is still sick, and asks her to help cover to keep him there. Clarence talks about his brother to Foreman while Cameron demands a test from House that only he can approve, and he initially refuses, but lets her have the test in return for doing two more of his clinic hours, but it shows no sign of infection and Cameron has to do an invasive biopsy. The brain scan on Clarence shows no abnormalities while Cuddy confronts House and demands Clarence be removed. However, Clarence starts bleeding from the abdomen and they’re forced to keep him.

Clarence’s bowels are turning necrotic and they use surgery to remove it, and House wonders why Clarence killed his fourth victim – the first three he has a motive for. House confronts Clarence over it and he admits the guy was watching him and somehow driving him crazy. From that House concludes Clarence has a tumor that secretes bursts of adrenalin and orders tests to confirm. Cameron is still hedging with Cindy and wants someone to acknowledge Cindy’s death. House talks to Clarence and wants him to have a MRI, but his tattoos have metallic ink that will cause him extreme pain. He agrees and they find the tumor. They get it out and Foreman wants them to offer the tumor as a reason for Clarence’s murder sprees. House isn’t particularly sympathetic but Foreman decides to testify at Clarence’s appeal, while Cameron finally gets around to telling Cindy about her lung cancer.