In Africa, a plane flies in and brings medical supplies to a local tribe. The man in charge is Dr. Sebastian Charles, who receives a riotous greeting from the locals. One man comes to him and asks him for help for his son, who fell and isn't breathing. Charles gives him treatment to wake him up – the boy's lung has deteriorated from tuberculosis. Later Charles is talking to a pharmaceutical company, Stoia Tucker, during a board meeting and needs more drugs for them, but they say they can't help. In the middle of his spiel he collapses.
House comes in to meet with Cuddy who tells him they're taking on Charles' case. House isn't impressed by Charles, who is already meeting with his staff. House doesn't believe it's TB, over Charles' assertion. Charles starts throwing around his weight and Cameron seems interested in him. House calls his staff back in with an emergency call. Chase notices a possible heart condition, sick sinus syndrome, and they begin treatment.
House meets with a woman in the clinic and determines she's allergic to her dead mother's cat, and is reluctant to take steroids. Then he watches while Foreman gives Charles a stress test – when House cranks it up they find the problem, an abnormal PR interval. They schedule him for a pacemaker and on the way to surgery, he offers Cameron a position and dinner. He suggests she could become a better diagnostician by working in the field, but then suffers from a headache and vomiting, collapsing on top of Cameron.
The new symptoms indicate sick sinus isn't the problem, and House sends Foreman to deal with his clinic duty, giving him his name tag. He meets with a Cecilia Carter who thinks she has cancer, and she insists he see her now. Foreman thinks its nothing but she thinks he's blowing her off and insists he do a biopsy - he agrees. They run a MRI test and Cameron notices the TB test patch she put on shows positive, forcing House to reconsider his diagnosis. Cuddy interrupts a chat between House and Wilson and reveals that Cecilia is complaining because she got hostile treatment from "House."
Charles refuses treatment and tests for anything else now that he thinks he has TB. Cameron starts Charles on treatment, and he's depressed that the medicine they can give him isn't available to his patients in Africa. After a little thought he refuses to take the medicine to highlight the medical shortages in Africa.
Dr. Charles calls a press conference and Cuddy goes along with it, while House decides to give Charles "third world" treatment. House turns up the heat, takes away his cell phone, and unplugs his TV. Charles goes ahead with the conference, showing photos of his village and pressuring Stoia Tucker. House tells Foreman to apologize while watching the press conference on the TV, then notices the lack of reddish color and the excess sweat. House barges in as Charles goes into cardiac arrest and they manage to revive him.
Charles lets them do tests but refuses to take the TB treatment, which House agrees he has. After a brief back-and-forth on their relative styles, Charles agrees to take the TB treatment while they run more tests. House concludes it's an extremely small tumor in the pancreas that reacts to stress. As they're heading down to test House's theory, they have to dodge Cecelia, who is with Cuddy. They start "poking" around in the pancreas and inject calcium – if the blood sugar drops they know the tumor is there. After a second dose they get a reaction but the blood sugar doesn't drop low enough. As Charles goes into seizures, it drops at the necessary rate to confirm the diagnosis and they revive Charles.
Later Cameron reveals she isn't going to go out with him and House suspects it's because Charles is going to live – Cameron denies that she was focused on Charles' image of a dying man. House then proves his statement by approaching Cecilia when she doesn't know he's…well, House. He hits her foot with his cane and then pretends to be a helpless cripple and fakes an apology in front of an unwitting Cuddy a few seconds later. Cecilia is impressed and leaves. Cameron says goodbye to Charles who is off to Africa, but not before he has another press conference. House isn't impressed and Wilson suspects it's because Charles enjoys his job…and House doesn't.