A teenager, Ben, is performing as a clown at a birthday party without much luck, and one of the kids finally punches him in the groin. Ben shoves the boy and the boy's father shoves Ben. As they struggle, Ben suddenly collapses, paralyzed.
The team gets the case and tries to determine how Ben had a mini-stroke. House notices that Taub has recently been in a fight with someone, judging by his wrinkled shirt, and Taub claims that it's from his diaper bag. When Taub realizes that the team isn't going to drop it, he admits that it was his ex-wife Rachel's boyfriend Phil. Phil wants Rachel and Taub's daughter Sophia to move with him, and a fight resulted. Taub points out that the patient was punched in the groin, but House disagrees that the punch triggered the stroke and prefers to discuss who will make a better father. Taub insists that he's the father and should have custody, but Park disagrees. Chase sides with Taub, and House points out that Chase and Park both have screwed up parents. He asks Adams about her parents, and she insists that they were good parents. House doesn't believe it. Taub suggests endocarditis and House orders a test to confirm.
Chase and Taub begin the test while Ben's mother Janey and stepfather Ron look on. They point out that Ben may be suffering stress because he just started performing, but Ben insists that he wants to get work as a circus clown. When Janey disagrees, Ben says that his biological father was a performer. Janey notes that Ben barely knew his biological father, who died of melanoma, and that he could aim higher.
House meets with Monroe, a patient who wants treatment for Type 2 diabetes. He says that the Monroe doesn't need insulin, but Monroe patient insists the bloodwork is several weeks old. House still refuses and tells him to leave, but the patient demands that House test him. House walks out and tells the staff to ignore the man, and then talks to Wilson. Wilson has tickets for the Rubio boxing match in Atlantic City and asks if House is cool if he goes without him. House isn't and tries to guilt Wilson into not going. When Wilson insists that he's going, House asks for the other ticket and says that he'll take care of the logistics.
The team meets and confirms that Ben doesn't have endocarditis, but he does have a thickened pericardium. Taub notes that Ben's father was a circus clown but House thinks he's mentioning it to bolster the case with his own daughter. Adams suggests Sjogren's and House orders IV immunosuppressants to treat. Taub gives Ben the treatment and assures him that he'll be out in a week, and Ben says that he has an internship at his stepfather's law office. He admits that he's not good at getting a clown, but he likes making kids happy, just like his biological father did for him. Taub tells him that he needs to hold onto that, and Ben admits that his father was always on the road. Ben's nose and mouth start bleeding and Taub realizes that it's not Sjogren's.
Taub returns to House's office and discovers that his boss has his daughter by Ruby, Sophie. House explains that Ruby dropped him off because Taub forgot that it was his night to have Sophie. Park suggests that he should let his wife move with the daughter, and Taub tries to focus on the case while comforting his infant daughter. House points out that Taub is overwhelmed and too vain to admit he doesn't matter to either baby. He then suggests aplastic anemia and says that Ben needs a bone marrow transplant. He tells Adams to stay behind and sends the others to find a match, and then tells her that she had five incompletes in her junior year. House figures that it means that her parents were fighting and she had an academic crisis as a cry for help. Adams insists that she's not messed up and therefore her parents didn't mess her up.
Taub drops Sophie off at the maternity ward and joins the rest of the team as they run the match tests. The team agrees with House about Taub's suitability as a father and fails to find a genetic match. As they go to the marrow registry, Taub tells Ben and Janey what's going on and asks if there is anyone on the father's side of the family. Janey says that her husband was an only child and his parents died young. When Ron and Janey worry that Ben will miss school, Ben says that he only plans to get his GED, and then he plans to take classes in magic and juggling. He insists that he wants to build a connection to his father by following in his footsteps. Ben then complains about back pains and his blood pressure drops.
Foreman is in a videoconference when House shows up in his office in response to his page. House can't resist annoying Foreman until he ends his conference early, and Foreman asks him about the invitation that House has received to give a medical speech at a conference in Atlantic City after the original speaker cancelled. Foreman wants him there and agrees to clear it with House's parole officer. However, he says that he's going to have them schedule House in the morning, well aware that the Rubio match is in the evening and that the conference is only two miles away. Foreman figures that House posed as the original speaker, called and cancelled, and suggested House as a replacement. He tells House to start doing his doubled clinic hours.
House goes back to see Monroe, who has a urine test that he wants checked. He insists that he's sick and has swollen ankles, and that diabetes runs in the family and he wants to get a jump on it. Chase and Taub in to tell House that Ben is having an allergic reaction to the donor platelets. They've been unable to find a genetic match and Ben's biological father died of a melanoma. House wonders why Janey didn't take Ben to a dermatologist. When Monroe insists on having his urine tested, House takes a sip of it and tells him that it's not diabetes. He then tells Chase and Taub to use cross-matched platelets and find out what Janey is hiding about her first husband's death. As he leaves, House tells them that Monroe faked the urine test with apple juice.
Chase and Taub ask Janey what type of melanoma that her husband had. She admits that he never had melanoma and that he didn't die, but is living under the name Mitchell Gordon. Ron is shocked that she kept it from him and Ben, and she says that Mitchell is a drunk who breezed in and out of her life, and Ben doesn't need to know that.
House meets with Wilson, who insists that he has to invite someone else. He points out that House still has an ankle monitor, and then figures that since House had screwed up parenting, he figures that everyone else must as well. House denies it and walks away.
Taub and Park track down Mitchell and tell him about Ben. Mitchell insists that he doesn't have a son anymore, but they explain that Ben needs a bone marrow transplant and a simple test could help save him. When Mitchell learns that Janey wants him to take the matching test at a different hospital than Princeton-Plainsboro, Mitchell refuses.
As they run tests, Chase tells Adams that House won't give up trying to prove that she was the result of bad parenting. She refuses rather than validate his theory, but Chase believes that House is right. He admits that his mother drank and locked him in his father's study, and he read the medical books. Adams claims that her parents had a lot of money that they made with gambling, drugs, and white slavery. She's well aware that Chase is transmitting their conversation to House by cell phone and shuts it off.
Taub tells Janey that she'll have to talk to Mitchell and convince him. As she starts to leave, Ben has a pleural effusion and starts hyperventilating. However, when they run a tube in, they don't find any blood in his lungs and Park tells Janey that it's his liver and a bone marrow transplant isn't necessary.
Back in differential, House meets with his team while having a hired ex-con, Vince, try to remove his ankle monitor. He figures that liver failure accounts for the symptoms, but they don't know what accounts for the liver failure. House is more interested in why Janey lied about Mitchell. When Park wonders how he plans to remove the ankle monitor, House insists that nothing is tamper-proof. Taub suggests that Ben's liver can't synthesize proteins and the fluid is leaking out of his blood vessels. When he calls Janey a selfish jerk who married up, House says that he's defending Mitchell because he wants to believe that there's an important biological connection between father and child. Taub wants to tell Ben but the others disagree. Chase suggests that it might be hyperammonesis. Vince sets off the monitor and immediately runs away, and the team wonders what to do since they can't treat for both. House tells them to get a consent from Janey to give Ben proteins. It will endanger Ben either way, but the results will be different and they'll know which diagnosis is correct.
Foreman and two officers track down House, who is soaking his feet in the hot tub. He realizes that he "accidentally" set off the monitor.
Taub tells Janey that the protein treatment is risky but that they can't find out anything if they don't do it. He then suggests that she come clean with her son and tell Ben about his father. Janey insists that Mitchell isn't Ben's father.
Monroe's wife Sandy comes in to see House and explains that her husband is obsessed with believing that he has diabetes. She asks House to provide a fake prescription so she can inject Monroe with it, let him believe his symptoms are gone, and then tell him that it was a fake injection. House isn't interested and walks away.
As they treat Ben, Adams gives Chase the cold shoulder. She insists that she's just being professional, but Chase believes that her parents screwed her up somehow and House won't rest until he finds out how. Ben complains about his left eye and they confirm that it's swelling up.
Taub is at home with Sophie when Ruby comes by. She admits that she went out with her girlfriends rather than get sleep, and she can't get a job as a nurse because daycare costs more than she would earn. Taub suggest that she stay with him in the guest room and he'll watch the baby so she can get some sleep. His page goes off but Taub turns it off and explains that he wants more time with Sophie. As Ruby goes to bed, Taub notices that Sophie is ignoring him and wonders if being with her makes a difference.
The next day, the team goes over Ben's new symptom and House notes that Taub didn't respond to his page. Taub finally accepts that it's Janey's decision and she's doing the right thing. When House figures that Taub patched things up with Phil, Taub explains that he had Sophie and that Phil will never be the father of Taub's daughter. House and Taub discuss the matter while the rest of the team focuses on the case. When Park suggests Burkitt's Lymphoma, House mutters about Monroe's swelling but then agrees with Park and orders chemo.
Wilson comes to see Foreman and suggests that he let House go to the boxing match, and that they'll stop by the conference to cover Foreman. Foreman refuses, explaining that his job is to be the jerk and that House has to accept his authority. He figures that it's Wilson's job to stay and spend time with House watching the match on pay-per-view and bitching about Foreman. Working together, they can get House through his parole. Wilson admits that Foreman is right.
Rachel and Phil come to see Taub, and Phil apologizes for demanding that Rachel and Sophia go to Portland with him. Taub figures that they're trying to play him, and Rachel figures that he's back working for House. As they go, they tell Taub that they've started calling Sophia "Sophie."
House checks Monroe's ankles for swelling and confirms that his heart rate is slow. He explains that the anti-diabetic meals that Sandy has been giving her husband have bok choy, which inhibits thyroid function and accounts for all of his symptoms. The food that Monroe has been eating to avoid diabetes is making him sick. Monroe realizes that he might not get diabetes from his father, but House tells him that given his weight problem he'll probably get diabetes anyway.
As Taub and Park treat Ben, he regrets not having known Mitchell. Taub tells him that his mother and stepfather have given him a lot and he should be grateful for that. Ben's systems shut down before they can begin chemo, meaning he doesn't have Burkitt's. As they try to come up with a new differential, Mitchell comes in. Janey demands to know why he's there and blame Taub, but Ron admits that he called him in. When it becomes clear that Janey won't let him see Ben, Mitchell starts to walk away. However, House realizes from his stride that he has late-stage syphilis and sexually molested Ben twelve years ago. As Mitchell leaves, House explains that the active infection would have died down, but it would have hidden in the arteries in Ben's brain. When the kid punched Ben in the groin, it kicked up the dormant bacteria. The immunosuppressants drove it into overdrive and the antibiotics they gave Ben destroyed the syphilis. Ben's immune system overcompensated, causing severe Jarisch-Herzheimer reaction. Ron asks Janey if it was true, and she admits that she found stains on Ben's clothing but he didn't seem to remember. She insists that she was just trying to protect Ben like she should have from the start. House orders IV penicillin and anti-TNF antibodies to treat the reaction.
As House leaves, Adams says that they're not done. She says that they should tell Ben the truth, and House says that Taub will have to make the choice because he's the only father among them and the rest of the team can't understand.
Taub treats Ben and the boy asks what was wrong with him. When he learns that he has syphilis, Ben asks how when he hasn't had sex and Taub hesitates. Later, he goes to see House and tells him that he didn't tell Ben the truth. House figures that Taub went with his brain, not his heart, and says that all parents screw up children because they go with their heart.
As House leaves, he runs into Adams in the elevator. When he says that the incompletes prove that her parents screwed her up, Adams says that she ran away from home because she didn't have lousy parents. All of her friends' parents were screwed up and she thought it made her friends deeper. Two months later she returned home and it took her parents years to get over it. House points out that she excelled to make it up to them, and that her parents screwed her up by not screwing her up. When he tells her that it's normal to be screwed up, but not to romanticize it, Adams admits that it's why she wanted to work with him.
Taub goes to see Rachel and Phil and tells them that he can't let them move. He then turns and walks away.
Wilson goes to House's apartment to watch the game but finds no sign of his friend. He turns on the game and sees Foreman and House using his tickets to get ringside seats. Sighing, Wilson grabs a piece of pizza and settles down to watch the game.