Cuddy wakes up in the morning and discovers that House is hiding beneath the bed waiting to surprise her. After a brief kiss, she goes to the bathroom, but then calls to tell him that there's blood in her urine.
At the hospital, House is there with Cuddy as she gets an examination... and brings the team with him. Chase finally explains that a sixteen-year-old is spitting up blood and they begin a differential. Cuddy tells them to get out, and House tells Taub to feed Ryan a camera.
Taub examines the patient, Ryan. After he convinces Ryan's parents Kay and Todd to leave, he asks the teenager why he's been cutting himself. He then tells House that Ryan has been suffering from depression and using marijuana to take off the edge. Taub orders him to check lead levels for contaminated marijuana and then gets Cuddy's test results and takes them to her office. They say that she's fine, and House suggest that she's worried over nothing and concerned she's turning into her mother. Cuddy agrees and says it's probably nothing, and he tells her to meet him in the cafeteria in ten minutes. Once he leaves, Cuddy calls to schedule an ultrasound.
Taub talks to Ryan, who is relieved that the doctor didn't tell his dad the truth. Ryan figures that Taub has dealt with personal depression, but Taub says that it's his job to notice things and suggests that the patient talk to the parents. Ryan says that he'd only be doing it to make them good, and Taub confesses that he felt he was the only one in med school that couldn't handle the pressure. He then notices that Ryan now has red spots in his eyes.
Wilson performs the ultrasound on Cuddy and tells her that there's a mass in her kidney.
The team goes into differential and Taub suggests that the symptoms began a year ago. House is busy on his laptop, and the team asks if everything is fine with Cuddy. He finally orders treatment for staph infection and goes to see Cuddy. She's in her office with a lawyer, drafting a will, and House admits that he hacked into her online schedule. However, he tells her that she has nothing to worry about. Cuddy insists that she's being a responsible mother, and says the biopsy to confirm the mass will be in the morning. House tells her that she should get it scheduled right away, and Cuddy points out it isn't necessary if he's right and she has nothing to worry about. Trumped, House leaves.
Taub finds Ryan meeting with a fellow student, Hayes, who wants money from him. Once Ryan is alone with Taub, he explains that he's selling anti-seizure drugs he got from a friend to Hayes, and that they're at his home. Taub gives him the money to pay the thug back.
Cuddy meets with Julia to ask her to be Rachel's guardian if she dies. Julia wonders what House thinks of the arrangement, and Cuddy claims that he hasn't been with her enough for it to be his concern.
An officer brings young Rachel home, where House and Wilson are raising her after Cuddy died. House tells officer she'll be fine, because she won't get caught again. The audience bursts into applause...
And Cuddy wakes up from her nightmare. On the nightstand next to her is a bottle of sleeping pills that she uses.
As Taub and Masters wait for Ryan to emerge from the bathroom, Masters congratulates Taub on doing something nice. Ryan comes out and tells them that he's peeing blood. The team meets to examine the new symptom, and House suggests it's a mass on the kidney. Chase realizes that he's talking about Cuddy, and Foreman tells House that he'll have to wait until the biopsy. Taub returns to the case and says that Ryan could be using some other drugs, but House disagrees. He orders treatment for antiphospholipid syndrome but agrees to let Taub search Ryan's house for drugs.
House goes to see Wilson and complains that his friend isn't with Cuddy, whose biopsy is due in an hour. When Wilson notes that House has been worried about becoming a bad doctor because of his relationship with Cuddy, House admits that he's lousy at providing comfort. He refuses to overreact, and Wilson tells him that as her boyfriend, it's his job to make her feel better. House agrees, much to Wilson's surprise and suspicion.
Chase comes to keep Cuddy company, on House's orders. After giving her antibiotics, Chase tries to make small talk and then assures her that House will show up eventually. Cuddy notes that Chase doesn't believe what he's saying, but says that she does.
Foreman and Taub go to Ryan's room to search, and Foreman wonders why Taub is so obsessed with the patient. He warns that fixing the kid won't fix Taub's own problems. They get a call that Ryan has lost feeling in his right arm, and Taub finds a year book with abusive comments and drawings on many of the photos.
House enters the ruined hospital and finds Chase waiting for him at the end of the hallway. Chase has been transformed into a zombie and attacks him. House valiantly fends him off with his cane and decapitates him with the ax concealed in his cane. As he mounts a shotgun on his cane, zombie Taub and Masters attack and he blasts them away, then goes after Cuddy. However, a zombie Foreman is waiting for him and House blasts him away. He follows Cuddy's screams and finds her being ripped apart by zombies...
Chase and Masters wake House up and he stalks off, wondering what could go wrong.
Back in differential, House is focused on Cuddy's case and figures she changed her name to keep him from rushing the results. Chase suggests clotting and Foreman agrees, and they wait for House to approve an angiogram. He insists that he's not worried and wants to get the results to reassure Cuddy, and then sends them to search for Cuddy's records. As they go, the others wonder why Taub is so concerned and insist that they did similar things in high school, and to House.
Wilson comes to see House, who is relaxing in the clinic room. He tells him that he has to be with Cuddy, but House says that he doesn't want to provide artificial support. Wilson stalks off as Masters arrives and tells him that she found Cuddy's biopsy results. It was inconclusive because they couldn't get a readable sample. House realizes that they'll have to remove the mass to get a workable sample.
Foreman comes home and finds House playing video games. House asks about Ryan, and Foreman says that they located a clot and are treating. He tells House that no matter how bad House is with Cuddy, not being there for her is worse. Foreman sits down to play, and tells House that when Cuddy breaks it off with him, House will be playing on his own.
Cuddy comes home to find House cooking dinner, and Rachel having passed her college exams. Wilson arrives with a 29th birthday cake for Mrs. House, and Cuddy notices that House isn't limping and none of what she's seeing possible.
Cuddy wakes up from her dream as someone knocks on the door of her apartment. It's Wilson, who has her scans. Cuddy looks at them.
At Foreman's, House gets a call from Wilson. He hangs up and tells Foreman that the scans show multiple masses across Cuddy's lungs. The symptoms match those of kidney cancer, meaning it's inoperable and fatal.
Taub and the team watch videos that he found on Ryan's computer, of Ryan ranting, creating a pipe bomb, and blowing up a nearby grove of trees. The others tell Taub that there's not enough to go on. They try to work out what to do for Ryan because the anti-clotting treatment isn't working, and Chase proposes surgery. They wonder where House is. Masters has checked with Cuddy, who doesn't know where House is. Foreman goes to see Wilson, who seems unconcerned. He finally admits that he's worried, but House is trying to make it about himself and he's not going to play along with his friend. Wilson tells Foreman that Cuddy believes that House will still show, and it's up to House.
Taub talks to Ryan's parents and explains the necessary procedure, and then tells him about the video Ryan made. Kay and Todd are more worried about keeping Ryan alive, and tell him to focus on that. As Taub and Masters watch Ryan's operation, Masters overanalyzes the facts and finally admits that she has no idea what to tell Taub. Meanwhile, Chase and Foreman operate and find the clot. It disintegrates when Foreman touches it with the probe, meaning it's not a clot.
The Mexican army gathers outside a church. Inside, House and Cuddy are loading their guns, and House suggest they go to an Australian bar in New Jersey for karaoke, shrimp, and fries. Cuddy notices that House is eating candy, just like in the other dreams, and House insists it means that she's suffering from stress. She tells House that she hoped he had figured out a way to deal with it, and House says that he can do better. Cuddy warns him that it might be too late and they charge out into the waiting guns... only for House to disappear, leaving Cuddy alone.
Cuddy wakes up from her dream and finds House standing in the doorway of the room. He apologizes for not being there sooner, but Cuddy tells him that she was sure he'd come.
Back in differential, the team tries to put the pieces together, and Masters warns that Ryan will be dead in a day if his liver continues to shut down. She wonders if they should call in House, insisting that he can't do anything for Cuddy and they need him for Ryan.
House holds Cuddy's hand and assures her that he won't sleep with anyone for a month if she dies. The orderlies take her into surgery.
The team comes up with the best diagnosis that fits, citrullinemia, and Foreman orders treatment to reduce ammonia levels in Ryan's blood.
As Cuddy goes under anesthesia, she dreams...
House performs a musical number with the hospital staff around Cuddy's body. He tells her to be ready for the judgment day. Cuddy laughs with House and then joins in, singing and dancing. She runs up a flight of stairs toward the sky... and finds herself alone in a void.
Cuddy wakes up after the surgery. House is at her side, and assures her that her tumor was benign and she'll be fine. The lung masses were a reaction to the antibiotics, and they'll clear up once she's off the drugs. He shows her the tumor and Cuddy considers it for a moment. She admits that she has a lot of fears, but all of the doors burst open when she thought she was dying. House gets an idea and tells the team to take him off of the staph treatment. Ryan has an abscess, burst of infection that burst when he was hit during basketball practice. Taub realizes that Ryan was hit by PVC shrapnel while testing his bombs. The plastic embedded in his stomach, spread through his body, and one of them dissolved in the brain when Foreman touched it. If they remove the fragments, the antibiotics can do their work.
At home, Cuddy recuperates while Julia tends to her. Julia asks if she's going to tell their mother, and warns against it. As Julia goes, she says that she put the sleeping pills away and notes that Rachel always calls them candy.
Cuddy goes to see House and accuses him of taking Vicodin. She realizes that he was stoned when he finally came to see her. House admits he did, and Cuddy says that she made herself forget for months. Her subconscious was telling her that he couldn't get through it without drugs. House says that it's a one-time thought, but Cuddy says that he takes it to avoid pain, just like everything else he does. She tells him that pain happens when he cares, and he can't love someone without making himself open to their fears and pain. House insists that he wanted to be with her, but she tells him that it's not enough. When he says that he can do better, Cuddy says that she doesn't think he can, and he'll always choose himself over everyone else because that's who he is. House begs her to stay, but she says goodbye and leaves.
Taub sends an envelope with the evidence on Ryan to the Trenton police.
Cuddy sits in her apartment with Julia, crying.
House sits in his bathroom and contemplates his bottle of Vicodin, and then opens it and shakes out a couple of pills. After a few seconds, he takes them.