Marriage counselor Joe Reese comes out to talk about a couple and offer advice to the audience. He talks about how men were raised to be strong, not emotional, and to deny vulnerability. As he talks, Joe starts to feel warm and takes a drink of water, and then stutters. His wife, Marlene, looks on from backstage as Joe finally collapses.
House's team gathers in the conference room and everyone is surprisingly friendly with each other... except for House. They review Joe's case and Chase is surprised that House doesn't think that Joe has psych problems, given that he advocates that men should become more like women. House insists that men can't control the way they act because it's evolution, while Park figures that Joe is preaching compromise and all relationships need compromise. Adams figures that Joe is just saying what his audience wants to hear, and everyone on House's team agrees that they should do a d-dimer. House then informs them that he's looking for a new team leader for Foreman's old position. As the team takes that in, House's green card wife Dominika Patrova comes in. She explains that she started a Ukrainian food truck business in Atlantic City, and reminds House that their immigration interview is due in four days. The interviewer will ask about their personal lives and supposed "marriage," but House isn't interested. When Dominika dares him to do it, House refuses and she makes him an offer he can't refuse.
Taub and Adams interview Joe, who explains that when three drunks beat him up in Milwaukee and broke his wrist, he realized that his macho routine wouldn't work for him. After that, he met Marlene and she changed his career and got him on a gluten-free diet, giving him a new direction in life. Taub wants the details on how his diet changed.
House comes to Wilson's office to get his apartment key back, and Wilson warns him that if he perjures himself to Immigration, he'll end up back in jail. He doesn't think House can remake himself into a perfect husband in five minutes and wonders what's in it for his friend. House admits that Dominika is paying him $30,000 to pull it off. The team arrives with the lab results, which show that the d-dimer came back normal. Joe has gone off red meat but that doesn't account for his fever. Adams is now impressed that Joe went against his basic instincts, but House doesn't think there's any natural about it. When he tries to get the team to start fighting over who will be team leader, no one takes the bait at first. Park finally says that she's in and Chase warns her against it. As they leave the elevator, House asks about the physical injury. Taub explains about the broken wrist but doesn't believe it could have caused the fever. House takes Chase and Adams with him and sends Park and Taub to make a copy of his apartment key.
In Joe's room, House asks the patient about his injury. He drops his pen and when Adams pends over to pick it up, House notes that Joe ignored him. Joe admits that he took a couple of knee shots to the groin. House then drops his pad and has Chase pick it up, and watches to see how Joe reacts. When Joe asks if House knows what's wrong with him, the doctor tells him that Joe had hot flashes. He didn't react to either sex and figures that the injury lowered his testosterone levels, and orders hormone treatments.
The team tests and confirms House's diagnosis, and Taub prepares to give Joe his first injection. Marlene asks if it will help with Joe's libido and admits that she's had to initiate things. Joe insists that he's attracted to her, and Taub tells them that the hormone treatment will increase the sex drive. Once they're done, Joe notices that he's peed himself and Taub warns him that he isn't going home quite yet.
Back in differential, Chase figures that the self-urination is neurological. House is more interested in having his team give him questions about Dominika's family. However, he thinks that the low testosterone and the urination are connected. Park suggests multiple sclerosis and House tells her it's that kind of thinking that will make her team leader. When Chase points out that no one else is competing, House makes Park team leader and tells her to have the team to test for MS while he gives Foreman the news. Chase and Adams both object to the promotion. After the meeting, Chase says that he thinks the position should go to someone with more seniority. Adams figures that Chase means him, while Taub warns that House is a dictator and won't need a team leader. Park figures it will look good on her resume while Adams thinks she can do something significant in the position. Taub warns that House wants them to fight and says that they should let House choose and move on.
Taub and Adams perform a LP and a MRI to confirm MS and assure him that advances are being made. Joe says that he's more worried about the testosterone and admits that he's feeling amped. He wonders if his change in lifewas chemical, and Adams says that it let him reevaluate what is important.
Chase goes to Foreman to get him to order House to drop the position, but Foreman thinks it's a good idea to bring structure to the department. He tells Chase that the team shouldn't turn on each other, but Chase insists that no matter what it shouldn't be Adams. Or Park. Or Taub. Foreman calls him on it and figures that Chase just doesn't want anyone else to have it.
House decorates his apartment with Dominika to make it more important, and she insists that House will have to go off of booze and coffee. She demonstrates her preference for dance aerobics while House answers the door. Park arrives with a series of tests for the two of them, and House figures she's currying favor for the team leader position. She agrees and starts testing.
Taub and Adams monitor Joe in the MRI chamber and argue over whether masculinity is ingrained and irrational. She turns it around, noting that femininity is rational. The MRI scan shows clean but Joe complains that he's seeing double.
The team returns to differential while Park takes fake honeymoon photos of House and Dominika. They rule out a brain tumor and elevated thyroid levels. Chase arrives with a flat-screen TV to bribe House, while Adams is sporting more cleavage. Taub reminds them that House is playing them and suggests myasthenia gravis combined with low testosterone account for the symptoms. House agrees and compliments Taub on undermining everyone else to fill the position, and orders treatment. Taub asks for a minute with House and warns him that he doesn't want what is going to happen. He figures that House just wanted to rile up the team since they were playing nice, and suggests that bonding is a good thing after what happened. House says that he's no longer a man because he's raising kids, lowering his testosterone. Taub doesn't buy that having kids has neutered him and says that it's help him grow up.
As Adams administers treatment, Joe admits that he has more energy and confidence. She says that it's because of the testosterone. Marlene brings him a hamburger and Joe compliments her ass, and then apologizes. She assures her that it's okay and Joe then starts talking about making a new business arrangement. Marlene is happy that he's finally made a decision after several months.
Wilson finds Park rehearsing House and Dominika in his office. When House recites a lot of detail about Dominika's friends, Wilson tells him that no husband would pay that much attention. Park points out that he's been divorced three times, but Wilson insists that he was married for 12 years. He realizes that he's getting dragged in but goes ahead anyway and starts rehearsing House in how a married man realistically reacts.
Later, Park asks Chase if he's going for the team leader position and tells him that he deserves it. However, she admits that she needs the money. They check on Joe, who says that he's doing better, but Chase immediately calls her out and accuses her of gaming him. However, Park points out that Joe's eyes are yellow due to jaundice, and they realize that something is wrong with his liver.
Back in differential, the team confirms that Joe's enzymes are out of whack. House is in a hurry to get to his interview, and Adams suggests that Joe has sarcoidosis. Chase disagrees, while Taub stands behind the diagnosis of myasthenia gravis since the treatment cured Joe's double vision. Adams suggests celiac, noting that the burger would have kicked it into gear. Chase doesn't buy that he has multiple diseases, and Park suggests lyme disease. The team starts arguing and House goes with lyme disease and tells them to treat while he goes home to meet the Immigration interviewer.
As Chase treats Joe, Joe becomes increasingly irritable and then realizes that he's being a jerk. Chase warns that testosterone can cause shortened temper, but Joe realized it and adjusted his behavior. Marlene comes in after learning that Joe has altered their deal so she will get more credit, and he insists that everything will be fine. Marlene hesitates and then leaves, saying she has to get some work done.
House and Dominika finish setting up the apartment and he gives her the wedding ring. He reminds her that she left it behind when she skipped town, and Dominika is impressed that he kept them. The Immigration man, Nate Weinmann, arrives and they invite him in.
Chase goes to see Marlene in the lounge and tells her to give Joe time. He explains that Joe is basically going through puberty and it will take him time to adjust. Marlene shows Chase a video of what Joe was like before his injuries, when he gave ruthless business advice at coaching seminars. She doesn't want the man that Joe was before he changed.
Weinmann goes over the couple's wedding history and they provide just the right amount of detail thanks to Wilson's coaching. He says that everything looks good and he's going to talk to the neighbors to get corroborating evidence. The first neighbor he comes to is... Wilson, out in the hallway and claiming to be their British neighbor. However, when the real neighbor comes in and wonders what Wilson is doing there, Weinmann realizes that he's being conned. House steps out and says that there's a simple explanation, and Weinmann tells him to be at his office the next morning.
The team goes over Joe's case and Taub notes that he hasn't shown improvement. House is on the speakerphone, calling from Immigration where he's waiting with Dominika and his attorney. Taub stands by his diagnosis but Adams wants to do an abdominal biopsy. House is forced to hang up when his lawyer takes the phone from him, but the team calls back and House claims it's a timer and goes to the restroom. It's Wilson, who admits that he can't find another angle. He suggests that House tell Weinmann that their marriage fell apart, but House warns that Dominika will be permanently deported. His friend warns him that there's nothing he can do. The lawyer summons House to the meeting, and he tells Wilson to tell the team to skip the biopsy and give the antibiotics more time.
Adams goes back to Joe's room and finds him arguing with Marlene. She isn't happy that Joe made the decision about their business without her, even if it turned out for the best. Joe tells her to step aside and let him be the man, and Marlene storms off. He admits to Adams that he doesn't know why he's getting so angry, and she tells him that after the newest dose he'll feel better. As she leaves, Adams notices the food on Joe's plate and says she wants to do one more tests.
At Immigration, the lawyer tries to claim that the neighbor is near-sighted. Weinmann doesn't buy it and says that they're going to deny the green card application, refer her to deportation court, and inform House's parole officer about the fraud. House has nothing to say and Dominika admits that they were committing a fraud but that they had fun during the week and it felt real to her. She suggests that it might have become real, and begs Weinmann not to send House to jail. House just stares in shock, but Weinmann tells her that he doesn't believe her. However, he admits that a judge might and decides to let her stay. However, he's going to conduct spot examinations and if they discover that Dominika and House aren't married, they'll continue with deportation. As they leave, Dominika assures House that she's far too smart to fall in love with him, leaving him speechless.
Adams runs the abdominal biopsy, which confirms that Taub was right about celiac. He figures she's doing it to score points with House, and Adams wonders why he's being a jerk. They get a page that Joe is having trouble breathing, meaning it isn't celiac. When House returns, they run differential and confirm that Joe's lung function is now at 60% and tanking. Adams suggests strongyloides, a parasitic infection that he picked up in Puerto Rico, but Taub warns that the treatment is lethal to someone with liver problems. They turn to House, who has been surprisingly silent, and he tells them to do it.
Taub is watching the video of Joe's earlier business coaching when House comes in. House figures that he's acting neutered again, and Taub admits that he wouldn't do the biopsy for celiac but Adams did. When he plays the video again, Taub notices that Joe's voice is lower. House dismisses it at first, but then notices him coughing. He goes to see Joe and Marlene and explains that Joe has silent thyroiditis, which includes chronic hoarseness. It comes and goes, and it's a symptom of polyglandular autoimmune syndrome #3. PAS moves from gland to gland, attacking the endocrine system and helped by the low testosterone. It would have caused celiac except that Joe was on a gluten-free diet. Eventfully it attacked the thymus gland, causing the fever and the myasthenia gravis, and when he started eating gluten then the celiac came on. They can treat the symptoms with steroids but Joe will still require hormone injections for the lowered testosterone levels.
Later, House meets with Adams, Park, and Chase and tells them that no one candidate prevailed. He now holds a contest to see who can suture the fastest. Meanwhile, Taub is treating Joe, who asks what happens if he doesn't take the hormone shots. He admits that he is feeling more like himself, but his life and career are based on him being someone else. Taub warns him about the side effects of the low testosterone, and Joe decides to take the risk because he's a better man without it.
Taub comes by to watch the team compete. House tells him that he was smart not to enter since he doesn't have the balls to compete, and Taub offers to split the $50 a week from the promotion if House gives it to him.
Back at home, House discovers that Dominika has redecorated and is exercising again, and calls out that he's home.