A patient's room is covered in blood.
After checking himself in the bathroom, House goes to the office where Dr. Walter Cofield is holding a disciplinary hearing concerning the patient in Room 209. Cofield turns on his recorder and informs House that he'll be deciding his fate. House recognizes the name and realizes that Cofield was Foreman's mentor, but Cofield refuses to let House turn the discussion to him. When he asks for the facts of the case, House tells him to read the file and starts to leave. However, Cofield warns him that if he goes by the facts, he'd have to suspend House. And if House is suspended, then his parole will be is revoked. House sits down and tells Cofield the case, which concerns a 32-year-old chemistry teacher, Bill Koppelman, who collapsed while jogging due to paralysis of all four extremities.
As House tells the story, Foreman pleads total ignorance and begs House to take the case because House is the best doctor he has.
When House takes his Vicodin, Cofield comments on it and asks if he was taking it during the case. House admits that he was, but that he's been taking them during every case he handles. Cofield figures they should figure out what went wrong so they can learn from their mistakes, but House says that it was nobody's fault.
House gives his team the files in his usual tactful manner.
Adams describes the meeting to Cofield, who wonders if she's trying to make House look bad to protect herself. She insists that she isn't, and that what happened wasn't House's fault. Taub tells Cofield he thought Bill had a liver problem, while Park believed that Bill had hydrocephalus. House thought both of their ideas were stupid and notes that Bill had low opening pressure on his LP.
House points out the low opening pressure, and Chase notes that the potassium levels are off. They go with beta blockers and steroids.
Cofield notices orange smudges on the reports and asks where they came from. House says that they might be Cheetos stains but Cofield doesn't believe it and asks for the truth.
At the differential, Chase has orange hair. He figures that House has pranked him, but House points out that he used Adams' shampoo. Adams insists that she didn't do it.
House admits to Cofield that he was the one who dyed Chase's hair orange, but he did it to relieve the tension. Adams feels otherwise, telling Cofield that House prefers chaos because it leads to better ideas. Cofield isn't convinced.
The steroid treatment is successful and Bill wakes up. Taub tells him that he's being treated for an overactive thyroid. Two of Bill's students, Jordan and Madison, come to see their teacher. They ask if he's sick because of the explosion in the chemistry lab.
Cofield wonders why the explosion wasn't in the patient history. Taub explains that it was an explosion in Bill's chemistry class, and nobody on the team knew about it because Bill was unconscious and Emily, Bill's wife, didn't know about it. He admits that he talked to Emily and if there was an oversight, he's to blame. Cofield wonders why House didn't talk to the patient, and Taub explains that House believes that avoiding patients lets him remain objective. House admits that it could be construed as lazy, but everybody lies so there's no point in talking to patients. Cofield asks if things might have gone differently if House had talked to Bill or his wife.
Bill explains that it was a controlled reaction, but the students explain that a student aide took a video and put it on Youtube. As they discuss the matter, Bill starts vomiting blood.
House describes Bill's symptoms as interesting. Cofield is surprised that House is so callous toward the patient's suffering.
Once he recovers, Bill tells Adams that his student aide deliberately added hydrofluoric acid to cause the explosion so he'd have something interesting to post on Youtube. The team figures that Bill coughed up blood because the fumes burned his lungs, and when he hit his head falling backward, it caused brain damage thus causing the paralysis.
When Park skips the DDX, Cofield asks her for more details. She finally tells him the truth.
House is wearing a gas mask because Chase put a stink bomb in his office for revenge. When he finds it, House takes it into the conference room. Everyone else gags and tries to come up with an idea just to avoid the stench, and Taub suggests aerosolized heparin to treat the burned lungs.
Cofield notes that the treatment has only been used on sheep, and figures that House used the stink bomb to pressure his team into coming up with unsafe medical ideas. House admits that the usual safe ideas wouldn't work. However, Park says that she disagreed and finally went to Foreman to complain.
Foreman tells Park that House doesn't do crazy for crazy's sake, and he must be doing it to help the patient.
Cofield talks to Foreman and asks why he didn't let him know that he was involved in the case. Foreman insists that his decision had nothing to do with what happened, but Cofield figures that Foreman is counting on him to protect the Dean of Medicine against having House on staff despite his parole. He warns Foreman that that he won't be able to help him if he finds against House, even if it costs Foreman his job.
Next, Cofield asks Adams why Bill was discharged. She explains that Bill was given a bath to wash off residue chemicals from the blast.
Adams and Park find a rash underneath Bill's arms. Park says it doesn't mean anything but they have to be sure, but Bill panics and tries to climb out of the bath.
Park tells Cofield that the rash was just an irritation and stands by her theory of concussion damage to the brain, with the psychosis caused by the steroid treatment. Adams thinks that the rash was a symptom of invasive strep. Taub believes that it was Wegener's. House tells him that faced with conflicting diagnoses, he ran a diagnostic trial.
House orders steroid treatments. It will cure Bill if Taub is right, but different symptoms will result otherwise, confirming that either Adams or Park are right.
Cofield is shocked that House chose a treatment that had a two in three chance of making the patient worse. House insists it was a perfect diagnostic moment, and but his theory didn't account for disobedience of his own team.
Chase agrees with Adams and prepares to biopsy for strep, ignoring House's orders.
Adams insists that treating for strep seemed like a good idea at the time.
As Chase prepares to use a scalpel to biopsy, Bill has another psychotic attack when he sees Adams' needle and attacks Adams. Chase tries to subdue him.
House refuses to blame either Adams or Chase, or both, but refuses to say who he does blame.
Taub and the orderlies manage to sedate Bill. However, they realize that in the struggle, Bill drove the scalpel into Chase's heart.
Adams tells Cofield that the scalpel only grazed Chase's heart, but she had to plug the hole with her finger. She tells Cofield that it was his fault and he tells her to continue her testimony.
Chase is rushed to the OR while Adams continues to plug the hole in his chest.
House defends his diagnostic test, since it proved Bill had a steroid-induced psychosis. Cofield is surprised that House felt it was more important that he was right then that Chase was badly injured.
House goes into the OR as Adams removes her finger and they operate. They manage to stabilize Chase, and House asks the team what Bill's heart rate was at the time of the psychotic attack. He orders Park to come with him, but she refuses, complaining that House didn't listen to her. House points out that she isn't helping Chase, she's just making herself feel better. However, Park still refuses to leave and House leaves on his own.
Cofield wonders if House is callous, and Taub says that callousness isn't a crime. When Cofield points out that House's attitude could have gotten Taub injured if he'd been in the room, Taub says that he wouldn't have done what Chase did. Cofield notes that he's saying that Chase is at fault, and Taub points out that they all knew a psychotic attack was a possibility. Despite that, Chase took a scalpel into the room, putting himself, Adams, and Bill in danger.
House goes back to Bill's room and finds the heart rate readout. He then goes to Chase's room, where he is recovering while his teammates sit at his side. He tells them to differential, and when they object, House says that there's nothing they can do for House. If it's a matter of caring, House points out that Bill has a wife and adoring students. Adams angrily tells him to shut up, but Chase wakes up and tells them to keep it down. He soon realizes that he can't feel his legs.
Twelve hours into the hearing, Cofield visits Chase to get his testimony. Chase doesn't feel that House's prank matters, and insists that it wasn't anybody's fault what happened. He admits that he was angry with House, but he wasn't distracted. Chase also points out that if he does walk again, it's because of House.
House refuses to accept that Chase is permanently paralyzed. He suggests a clot in the ridicular artery and they take Chase to the OR to probe for the clot. They find it and start to remove it, but warn Chase that the damage could be permanent. House comes in and starts a differential on Bill because his kidneys are failing. They have to do a DDX now because Foreman is having Bill transferred since believes that the staff can't remain objective.
Cofield asks Chase if House was trying to drag people away in the middle of a surgery that could restore his mobility. Chase explains that House just needed an excuse to see if Chase was okay. Cofield sees Chase's toes twitch and confirms that Chase should get back some or all use of his legs. He then asks why Chase took the scalpel into Bill's room even though he knew there was a chance of a psychotic break. Chase says that he thought he was right about the rash, and that he'd do it again. Cofield says that he thought so and starts to leave. When Chase asks what he means, Cofield tells him that he defied House either because House has established that it's okay, or the prank war distracted him, or Chase wanted to beat House. It comes down to House no matter what, and as a result Chase may never walk again.
House goes to see Cofield for the last part of the hearing. Cofield asks if House knows about Chase's improvement, and House admits that he has no idea about it. After a moment, Cofield turns off his recorder and asks House if he's really that cold, and suggests that he should apologize to Chase. House insists that he didn't do anything wrong and starts to take some Vicodin. The bottle is rigged to shoot confetti, thanks to Chase. House gets an idea, tells Cofield that there were two explosions, and walks out.
House goes to the admitting ward but discovers that Bill is being transferred and Foreman has given orders to everyone to ignore House. He turns to Emily and tells her that Bill has a tumor in his lymph nodes. The explosion caused the cancer cells to break loose and spread through Bill's body, accounting for all of the symptoms. The steroids triggered the psychotic break. House tells her to inform Bill's new doctors about the tumor, but Emily points out that he's been wrong all along and leaves.
When House goes back to Cofield's office, Foreman tells him that Cofield has left for the night and will give them his decision the next day.
That night, Chase, Foreman, and Cofield are all unable to sleep. House goes to Chase's room and watches him as he sleeps, and then leaves.
The next day, everyone meets with Cofield. He tells them that the case is a fiasco, and House is brilliant but a fiasco. As he tells them that he won't exonerate him and condone his activities, Emily comes in and tells them that House was right. He has a lousy attitude, but Bill's doctors found the tumor and treated him, and he'll make a full recovery. Once Emily leaves, Cofield says that House is effective and he won't deprive the hospital of his services. He announces that the stabbing incident is officially nobody's fault. However, as Cofield starts to leave, House calls him a coward. Angry, he denounces Cofield for giving in to Emily's sob story rather than judge the case on his merits. House then gets up and walks out on everyone.
House goes to see Chase in the physical therapy room as he tries to relearn how to walk. He asks how Chase rigged the Vicodin bottle, and then explains that he put dye in Adams' shampoo because he knew Chase was out late, and showering at the hospital using Adams' shampoo. House put the dye in just to teach Chase not to come in late. When House says that it wouldn't have been fun to just ask him not to be late, Chase points out that none of it was fun. House tells him Cofield's decision that it was nobody's fault, but then says Cofield was wrong and apologizes. Chase doesn't acknowledge it and says that he's busy, and House walks away.