At a gambling joint, House is watching a horse race and tries to place a bet. A guy slows down the line when a woman, Anica interrupts him to get things going so House can place his bet. They compare betting notes but when House turns away for a second she collapses in convulsions and House notices bruising on her chest and sends her to the clinic.
The staff meets with Foreman running the meeting and ordering House to do the medical history – House is skeptical of his diagnosis of a sexual or alcoholic-based disease. Afterward the two spar in front of Cuddy but she goes with Foreman, but warns him he'll have full responsibility. House runs Anica's medical history and checks her, thinking she might have Cushings. Anica recognizes the disease and reveals she had it a year ago and had the tumor on her pituitary removed. In the MRI they check to see if the disease relapsed, without success, and Foreman orders more tests. House performs a LP on her spine with a needle, causing intense pain, then orders the observing Cameron to meet with him. House asserts she still has Cushings and Foreman relents despite his assertion she's suffering from alcoholic withdraw.
Foreman finds out House orders MRIs for the entire maternity ward and confronts him over it, and it becomes clear House is going to push it as far as he can. Cameron and Chase find a mass on her pancreas and give her two months. Cameron breaks the news to Anica who takes it very calmly. They take her into surgery for a biopsy with House assisting. Later House is called in to check out a woman with a vaginal infection resulting from…strawberry jelly that she used as a spermicide. The biopsy proves negative and Cameron suspects she has Munchausen's and injected herself with ACTH to bring on the symptoms herself. Foreman sends House and Cameron to break into Anica's house, and House gives Cameron a lift on his motorcycle. At the apartment they find she's visited several doctors but also has three pairs of eyeglasses, possibly confirming she has a tumor pressing on the optic nerve.
Foreman vacillates between the two possible diagnoses until he eventually orders a test – but House calls him on giving in just to play it safe. Cameron takes the consent form to Anica and accuses her of faking her symptoms and leaves a bottle of pills behind. Foreman goes to Cuddy who is less than sympathetic with his griping and suggests it could be permanent. As their meeting afterward they get a call to call off the test – she's urinating orange, due to the pills Cameron left behind. Anica took them to bring on new symptoms, confirming Cameron's diagnosis.
While House goes through the files, Anica denies doing anything to herself. House then confronts them with his belief that her levels are still low and that she has Munchausen's and aplastic anemia. He suggests a bone morrow biopsy but Foreman is reluctant until House suggests they run tests on the initial blood tests –if the tests are positive, Foreman will grant the biopsy. There's not enough blood but House flirts with the technician into doing it anyway. Foreman approaches Wilson and asks if there's anyway House will take him seriously as a boss. Wilson can't help him but agrees to keep silent on it. House confronts Foreman with the test that shows positive, but Foreman quickly spots that it's a ringer. When he refuses, House appeals to Chase since Foreman has barred him from Anica's room. Cuddy and Foreman catch on and discharge her without the test.
House intercepts Anica outside and offers to do the test outside on the bench while sympathizing with her history that led to her Munchausen's. He'll give her a cocktail of insulin and colchicine that will confirm his diagnosis…unless she's faking, in which case the injection will kill her. She says she hasn't taken anything else and House gives her the injection then leaves so he won't be connected to her seizure.
Foreman's wondering about how Anica collapsed just outside the hospital when Cameron comes in with a confirmation of the anemia. House rubs it in then Foreman goes to meet with Anica and tell her what she's suffering from. Either she can get a marrow transplant which could kill her, or go on a lifetime regiment of injections. She agrees to the transplant and they have to kill the old bone marrow then keep her in sterile conditions for two weeks until they can perform the transplant. House is in her room and finds a piece of clothing, and realizes she has an infection but her faked symptoms were suppressing the infection. House advises a safer course despite the low white cell count, and comes up with...colchicine , that he gave her. There's bacteria inside her bruises which got into her organs.
Foreman goes to Cuddy and says he'll take her offer, but Cuddy refuses and points out House saved Anica's life despite his actions. Foreman leaves, disgusted with what House did and what it could lead to. House and Wilson leave and Wilson points out that House couldn't handle it with Foreman as his boss despite his claims he's fine with it. Anica is at another hospital with her new symptoms, while at the gambling joint House places a major bet to win.