Patty Mishner, the head of Woman's Majority, arrives at a company meeting with her assistant Lou to give them advice on how to deal with women's issues. As she talks to the board, Lou starts hallucinating being covered with ants and starts ripping off her clothing.
House is in the coma patient's room playing video games and ducking Cuddy. She finds him anyway and tells him that Wilson's back. House says Wilson wanted time alone and left him to himself. Foreman arrives and informs them about Lou's case. Cuddy suggests someone else takes the case, but House takes it rather than talk to Wilson. The team meets and goes over Lou's travel history and the possibility she's taking amphetamines to keep up with her job. Taub suspects a B-12 deficiency due to work pressure but Thirteen believes she has cancer and doesn't think it's work-related. House jumps in and talks about her having Huntington's Chorea, then backs Taub's diagnosis and orders vitamin treatments. Afterward, the rest of the team approaches Thirteen, who denies having Huntington and accuses House of deflecting his problems into her.
Lou is on the phone talking with her boss when Thirteen arrives to give her vitamin boosters. Lou suddenly says she's had a bowel movement, but Thirteen realizes she's bleeding anally.
House goes to see Wilson, who says that he's leaving. House suggests that emotional pain fades away but Wilson doesn't believe it. When Thirteen informs him about Lou's condition, House sends her away and tells Wilson to get over the textbook grief reactions. Wilson cuts him off and leaves.
Thirteen and Taub conduct a rectum probe and Thirteen isn't thrilled with House putting his personal issues before the patient. They don't discover a source for bleeding but Kutner reveals that the pre-procedure test for pregnancy showed positive. They administer an ultrasound to Lou who defends her choice to relieve her needs. However, they find no sign of a fetus. They go to House and confirm the B-12 treatments are kicking in but Lou's heart is still slowing. House tells them to go ahead and confronts Wilson again and tells him that he's suffering too. Wilson doesn't take that well. The others come in and Wilson informs them that he's leaving. House focuses on the case again and goes to see Lou. He mistakes her for being age 27 instead of 37 because of her good skin, then administers another ultrasound. He determines the fetus descended into her intestines and orders surgery to remove it. Thirteen confronts House, insisting they should try to save the fetus. He refuses and questions her judgment and thinks the knowledge of her condition is coloring her decisions.
Thirteen goes to Lou, who is fine with having the fetus removed. Meanwhile, House goes to see Cameron and suggests she talk to Wilson because she lost her husband.
Chase starts the operation, but Lou's blood pressure starts dropping and they just manage to stabilize her and remove the fetus.
House goes to Cuddy and suggests she block Wilson's references to other hospitals. Cuddy would rather House apologize to Wilson, but he refuses because he doesn't feel responsible for her death. She tells him to tell Wilson he feels like crap but he insists it's meaningless.
Lou is now having neurological problems and flat lines, and they call House. House is in Wilson's office and asks if apologizing would change anything. When Wilson refuses to consider it, House states that he'll go home and ignore his patients until Wilson agrees to stay. As Lou's condition worsens, House leaves the hospital.
The team goes into differential without House, and with Cuddy supervising. She tells them she's confident in their abilities and leaves. Thirteen suggests MS, which matches all the current symptoms, and Foreman authorizes interferon treatment. Cuddy goes to see House and point out that he's running away as well, but House closes the door in her face.
Lou regains consciousness and wants House to treat her. She insists she'd be nothing without Patty and when Thirteen objects, Lou admits that not everyone is equal. She starts to shiver due to fever, disproving the MS diagnosis.
House comes back to the hospital to confront Cuddy because she's managed to disconnect his cable. She's also taken the doctor's lounge remote, and called Wilson in on a fake emergency. She refuses to give up his salary history or give House cable access until they both sit down and work things out.
The team goes over the recording of the surgery and Kutner spots a possible ganglioma that could be causing the symptoms. They decide they'll have to open Lou up again and determine exactly what is it. Meanwhile, House and Wilson aren't interested in talking about anything except Cuddy. She finally tells Wilson he can't run away and he storms out, noting that no one at the hospital liked Amber.
Chase believes the lump was a hematoma which is why he ignored it during the surgery. He refuses to operate, insisting that Lou won't survive a second round of anesthesia. Thirteen insists he would agree if it was House, but he notes they're not House. Kutner comes up with an alternative: inserting a lighted probe up her rectum and finding the lump, then pushing it up to the skin and removing it.
Thirteen informs Lou about the procedure, and the assistant reveals that she was fired. Thirteen wonders how Lou can let Patty treat her that way, but Lou has no problem with it and admits she'd rather aspire to greatness then achieve it.
They go ahead with the procedure and cut out the suspected ganglioma. Meanwhile, Cameron talks to Wilson and warns him that he's not making a rational choice even if he thinks so now. She admits the pain eventually gets easier but never goes away, and he can't handle seeing anything that reminds him of Amber. She says she has the same problems with her dead husband even now, and warns that there's no "right" choice to make.
They determine that the lump is not a ganglioma, but indicates amyloidosis. They don't know what the cause of it is and have to determine it or she'll never leave. They all disagree on the cause, so Foreman takes the information to Wilson. He suspects lymphoma, confirming Thirteen's guess, and Foreman orders chemo. He tells Wilson that he should leave: everyone else would and anything that might make his life easier would help.
Thirteen talks to Lou as she receives chemo. Lou says she's feeling better and says that Thirteen might be able to aspire to more. In response, Thirteen explains she has Huntington's and she wants to make her life matters before it runs out. Lou admits that Thirteen has inspired her and she's applying for a job at a foundation.
House has obtained the nurse's remote and is preparing to watch his soaps. Cuddy asks him why he thinks Wilson is leaving, and then says she hoped he would say something insensitive and… true. She figures he's afraid to learn why Wilson is really leaving. House is thinking about something else: he goes to see Lou and notes she know looks like 37. He tells them to stop the chemo and takes a sample from a bruise on her leg. He reveals that she has diffuse lepromatous leprosy, acquired when she was traveling overseas. The symptoms include smooth skin, explaining why Lou looked 10 years younger. He orders antibiotics and leaves for his soap opera, and Thirteen is irritated that House was right.
Later, Thirteen talks to Lou, confirming House's diagnosis. Lou admits that she's going back to work for Patty and she doesn't want her to change: she's happy being an employee rather than an employer. House talks to Thirteen later: she considers Lou an idiot but House notes that only dying changes everything. Realizing what he's said, he goes to Wilson… and apologizes. Wilson admits he doesn't blame House, and even tried to find something to blame on House. But he warns that they're not okay: he's leaving because he's tired of enabling and protecting House. They're not friends any more… and Wilson wonders if they ever were.