An African ruler, President Dibala, drives to visit his son at university against the advice of his aide, Joseph Ntila. Men in a black van cut them off and Joseph draws his gun. One man gets out and says he's serving them with a civil subpoena and then drives away. Joseph assures Dibala they can ignore it but Dibala simply stares at it for a moment and then collapses, vomiting blood.
At Princeton, Cuddy asks Cameron and Chase to work on Foreman's diagnostic team now that he's fired Thirteen and Taub has taken a new job. Chase admits it would be interesting but Cameron points out that the patient is President Dibala, a ruthless tyrant suppressing an ethnic rebellion in his country. Chase admits that's what it's interesting and Cuddy notes that Dibala is a guest of the U.S. and scheduled to speak at the UN. She asks them to sign on and Cameron reluctantly agrees.
As they go to see the patient, Foreman admits he knows it looks bad and it might force him to break up with Thirteen, but there was no other choice. They arrive in the conference room to find House already there. He admits he won't have his license for a month and admits that Foreman is in charge. Dibala suspects an assassination attempt but Foreman says that there are no traces and recommends coartem treatment for malaria brought on for a bug bite. House interrupts and notes that Foreman is rushing through the diagnosis because he's rushing out of the room because he's mad at House. He tells House to say what he has to and House suggests that it may be a poisoning attempt using dioxin. Foreman reluctantly orders olestra treatment for dioxin and House says they should go to see Cuddy.
Cameron and Chase administer the treatment and Dibala notices from his accent that Chase spent part of his childhood in England. Dibala notes that they had priests in the village where he grew up, but they weren't able to help his sister when she died of consumption.
Foreman complains to Cuddy that he fired Thirteen because he thought House was gone for good. House admits that he needs diagnostic medicine in his life and offers to explain to Thirteen. Cuddy agrees to let him sit in unofficially. Foreman goes to see Thirteen and explains that he won't be in charge for long and offers her her old job back. She tells him that she doesn't want the job because she figures that he wanted to break up with her and used his new position as an excuse. She refuses to talk to him about it or go out to dinner with him.
Chase meets with a follow-up patient, Ruwe. He reveals that Dibala killed his wife by ordering his Youth Labor League to kill her and dump her in their yard. Chase tells him to talk to the UN but the man insists that Dibala is preparing a final war to eliminate Ruwe's people, the Sitibi, and the UN will do nothing. Ruwe insists that Dibala can't recover but Chase says there's nothing he can do.
House goes home and discovers that Wilson is eating chicken without garlic. House wonders if he's losing his sense of smell and notices that Wilson wasn't wearing shoes two nights in a row. He realizes something is up and pounds on the floor. Someone pounds back and Wilson admits that his neighbor has been complaining since House moved in. Wilson warns that the man, Murphy, is a decorated war hero who lost his arm and a complete jerk. However, he's on the condo board and Wilson wants to get his garden renovated. Cameron calls and interrupts, telling House that Dibala is having a heart attack.
House returns to the hospital and diagnoses Lassa fever. Ribavirin can be used to treat it. However, Foreman reports that Lassa fever isn't found in Dibala's country. The rash has disappeared, ruling out dioxin poisoning. Dibala hasn't been anywhere that he would get Lassa fever. However, House suggests that Dibala met with Liberian trade union members, and there was an outbreak of Lassa fever in Liberia. Foreman gives in and orders ribavirin.
As Foreman administers the treatment, Joseph objects but Dibala overrides him. Dibala asks if Foreman has a girlfriend and notes that Thirteen is standing in the hallway. She tells Foreman that she's been called in to interview at Harvard. However, she never sent her resume. Foreman admits he called in a favor and Thirteen agrees to have dinner with him.
House comes back to Wilson's apartment and finds Murphy in the hallway. Murphy realizes that the cane is causing the banging noise and he can't sleep. House tries a conciliatory approach but Murphy ignores it and orders him to keep it down.
Dibala pages Cameron and tells her that he's brought in a woman, Ama, who recovered from Lassa fever two years ago. His own counselors have informed him that blood will serve as a cure. Despite the fact they have Ama's signed consent, Cameron. Cameron refuses and takes it to Cuddy, who makes sure that Ama explains the situation. Ama says that she is Sitibi and Cameron realizes that she's being coerced, but Cuddy orders Cameron to go ahead because they have no choice.
In the hallway, Chase notices a black orderly going toward Dibala's room and realizes it's Ruwe. Chase yells an alarm and runs in to find Joseph brutally beating Ruwe. The U.S. agent, Bass, pulls Joseph off of the assassin while Chase confirms that Dibala wasn't hurt. He wasn't shot, but Dibala's right eye is bleeding internally. Chase tends to Ruwe's injuries, and Ruwe explains that the woman he described earlier wasn't his wife, but Dibala will now do the same thing to all the Sitibi. At home, Cameron is worried that Chase was at risk. She tells him not to yell a warning next time.
The next day in differential, the team determines that the bloody eye was caused by an enlarged lymph node, giving them another symptom. House refuses to speak, but starts miming suggestions to Chase. He suggests an infection and Foreman disagrees, insisting it's lymphoma. He finally gives House the okay to speak and House disagrees, noting Dibala's LDH is low. Foreman believes his liver function is masking the LDH and orders a test for lymphoma. As House leaves, he suggests that Foreman close the blinds. Puzzled, Foreman does so and discovers that House wrote his prediction of lymphoma long before they had the meeting.
Wilson complains to House that Murphy ended up thinking House was a jerk. House insists that he was polite and didn't start anything, and suggest that Wilson blackmail Murphy with the knowledge he didn't serve in Vietnam. House explains that he saw Murphy holding private medical insurance, not VA, and he's too young to be a vet. He checked further online and there's no reference to him in the Vietnam records. House figures Murphy is faking it to get respect but Wilson isn't interested and tells him to write a letter of apology. When House insists Murphy is a jerk, Wilson says that it's easy to be nice to nice people. House needs to work on being nice to jerks.
As Chase tests for lymphoma, he asks if Dibala is preparing to commit genocide against the Sitibi. Dibala insists that he's trying to prevent genocide and admits his son hasn't spoken to him in years because of what the American papers say about him. When Chase asks about the Youth Labor League, Dibala admits there have been abuses and he insists they won't happen again.
House goes to drop the letter off at Murphy's door just as the housekeeper leaves to dump the trash. House thinks about going inside for a moment and then puts the letter on the doormat. As he turns to go, he slips on water from housekeeper's bucket, ruining the letter. He tries to mop up and ends up inside the room when he puts the letter on the desk. However, as House leaves he notices a Canadian flag on the wall.
Chase checks with Cameron and asks how she's doing. She assures him she wasn't joking about letting Ruwe kill Dibala. They argue the merits of murder vs. war and Cameron refuses to feel any sorrow for Dibala if he dies. She then confirms that Dibala doesn't have lymphoma.
House is waiting for Murphy when he comes home and points out that he's sure that Murphy is faking. Murphy explains that Canada sent troops to reinforce the '73 accords and he lost his arm trying to save a boy. Even now he suffers phantom pains. House is taken aback and quickly leaves.
Cameron and Chase tell Dibala that he doesn't have lymphoma and realize he can't grasp what he's saying.
Foreman and Thirteen meet for dinner and she notes that Foreman could have stepped aside and let Cameron or Chase take over. Thirteen insists she wants to understand him and asks what he would do if he could do it again. Foreman insists that he made the right decision and Thirteen gets up and walks away.
Joseph asks Cameron for her confidential medical opinion and asks if she believes Dibala is sinking quickly. She admits that he's already in decline and neurons won't grow back. Cameron notes that Joseph can't trust anything that Dibala says. Chase reports that Dibala's fever is rising.
House diagnoses sclerodoma based on skin tightness on Dibala's admission photos. Foreman disagrees, insisting it's blastomycosis infection. Chase agrees with Foreman and Foreman warns that if they treat wrong, it'll be too late to do anything else. Cameron tentatively backs House but admits she doesn't care if Dibala lives. House tells her to take a stand and Cameron backs Foreman. When House threatens to go to Cuddy, Foreman tells him that it's his department and they'll treat him for blastomycosis.
As Cameron prepares to give Dibala the injection, he grabs her hand and says that he knows what she said to Joseph, and set it up for Joseph to take command. He accuses her of trying to inject an air bubble and tells her it's not so easy to kill when she has to do it herself. Cameron injects the antidote into his IV and nothing happens. Chase tells Dibala not to touch her again, but Dibala insists that he showed her a valuable lesson. He insists that Cameron is too weak to act on her own beliefs, like so many other people around him. Dibala accuses them all of being appeasers and Chase asks what he's going to do about the Sitibi. The dictator says that he deals with death and danger and Chase demands to know what he plans to do. Dibala insists he'll do whatever it takes to protect his country.
Wilson tells House that he convinced Murphy not to press charges in return for kicking House out. He tells House just to stay out of it and believes that he's changed enough to realize that.
Cameron orders a test for sclerodoma and admits that now that she had to make the choice, she wants to keep Dibala alive. The test proves positive but Foreman warns that it only points to sclerodoma but it's not conclusive. Foreman stands by his decision. Cameron asks if Foreman has told Thirteen that he was wrong, and warns him that he retrenches due to insecurity when he's wrong on important decisions. If he's wrong on this, the patient dies. Foreman okays their treatment of steroids for sclerodoma.
House breaks into Murphy's home and drugs him. He ties him up and gags him, apologizes, and admits he's having a setback. He then takes Murphy's stump and places it in a box. He then puts his hand in the box and shows him that he's set up a mirror aside. It appears that Murphy has both arms. House tells him to clench his real and phantom hand and then let them both go. Murphy realizes that the pain is gone for the first time in 36 years and sobs in relief.
Dibala starts bleeding out into his lungs and Cameron and Chase try to stabilize him. They discover a dozen ruptures in his heart and try to revive him, but Dibala flatlines and they're unable to bring him back.
House comes to see Foreman, who isn't sure if he killed him Dibala by sticking to his opinion or abandoning him. House tells him he'll have to discover but Foreman points out that Dibala's body is under lock and key and the government will be taking it back the next day.
Foreman goes to see Chase and tells him he couldn't get into the morgue. However, he has the sign-in sheet for the morgue and it shows Chase signed in just before Dibala died. Foreman notes that one body had sclerodoma and accuses Chase of messing up Dibala's test. Chase says that Cameron had nothing to do with it and he couldn't stand by and heal Dibala just so he would go back and kill the Sitibi. He warns that if Foreman reveals what happened, Dibala will become a martyr. Chase tells Foreman to at least warn him if he tells the police so he can tell Cameron first. When Foreman wonders if Chase thinks he can get away without consequences, Chase admits he doesn't think that at all.
House returns to Wilson's apartment and Wilson notes that Murphy called and sounded happy. Murphy is approving the garden expansion and isn't going to press charges even if House stays. Wilson wonders what House did and House says that he was nice. He asks if Wilson wants to know anything further and Wilson agrees to give him the benefit of the doubt.
Dibala's son goes to the morgue to get his father and weeps over his body.
Chase goes to bed, looks at the sleeping Cameron for a moment, and tries to go to sleep.
Foreman burns the morgue sign-in sheet.