Darrien, a woman with a knife wound in her side, steals a car and drives erratically through the streets. She makes her way across town, crashes onto a sidewalk, and goes inside to the apartment of a friend: Hadley. Hadley says that she needs to take Darrien to a hospital for treatment, but Darrien refuses and makes Hadley promise not to take her in, since it would reveal her to the authorities.
House is entertaining a prostitute, Emily, and explains that the white powder he’s taking is to regenerate his leg muscles, rather than recreational use. She doesn’t believe him and House proves what he’s saying by picking up an amp stack and carrying it. He drops it due to a cramp and spills the compound, and tells Emily that he won’t need her services after all.
Hadley checks Darrien’s knife wound and determines that the liver is nicked, but has clotted off and there’s no internal bleeding.
Foreman comes home and finds Taub talking to Ruby from the hospital. She quickly leaves and Taub explains to Foreman that Ruby is pregnant. He gets up to get a drink.
Darrien explains that there was a raid at a crack house and Andre, her partner, stabbed her as a distraction. The police left her there to go after Andre and left her there. Darrien insists that it’s her fault that she’s using again, not Andre’s. Hadley discovers that Darrien has no pulse in her left arm but is fine on her right side. She calls Chase and asks him to bring an ultrasound scanner. Hadley claims that she has a leak in her bathroom and can’t afford a repairman.
House goes to the lab to see Dr. Riggin, who explains that all of the rats in his trials died of tumors. They all suffered from cramps and then died.
Chase brings the ultrasound to Hadley, who takes it from him and tries to get rid of him. He realizes that she lied about the leaky pipe and Hadley reluctantly lets him in. When he sees Darrien, Hadley explains to him for the first time that she was in prison.
House runs a MRI scan on his leg and finds three tumors.
Hadley continues explaining, telling Chase that she was in prison for mercy-killing her brother. She tells Chase to focus on Darrien and warns that she has Hep-C. They confirm that it’s not an aneurysm and Chase finds a possible lipoma, a fat-filled sac that is blocking blood flow. They try to drain some of the fat and find it filled with blood instead, meaning it’s not a lipoma.
Taub and Foreman go to a strip club, and Tab wonders why Ruby wants to keep it and why she thinks that he’s a suitable father. Foreman figures that Taub is there ignoring the strippers is because he’s considering it, and Taub offers money to a stripper, Dina.
Hadley and Chase finish draining the blockage, and Chase wonders says it must be toxic exposure. Hadley disagrees, saying that the symptoms have to be related to the stabbing. She suggests that Darrien’s body has worn out her clotting to deal with the stab wound, and more masses could form. Hadley asks Chase to go to the hospital and pick up clotting factor. He reluctantly agrees.
House goes to his bathroom, sterilizes his bathroom as best he can, gets into his tub, and then cuts open his leg to remove the tumors.
As they wait for Chase to return with the clotting drugs, Hadley asks her what is responsible for the drugs. Darrien refuses to talk to her about it.
Using a local to suppress the pain, House manages to cut out one of the tumors. However, he’s unable to do the next one and reaches for his phone. He calls Wilson, who is asleep and doesn’t hear it.
At the strip club, Taub gets House’s call but figures he needs a ride. He then tries to get her opinion on what she would do if she was in Ruby’s position, but she doesn’t want to get involved. Taub notices an asymmetrical mole on her abdomen and tries to touch it, and she calls over Bobby the bouncer.
House tries to call Hadley, but her phone is next to Darrien, who ignores it. Darrien sees a teenager with a gun standing at the foot of the bed. She orders him to put the gun down, and a shot rings out as he goes down with a hole in his head. Hadley hears Darrien crying and goes in, but there’s no sign of a shooter and Hadley realizes that her friend is hallucinating.
Unable to contact his friend or his staff, House finally calls Cuddy. She wakes up and finds Rachel in her bed, watching an adult cartoon about Brownbeard the Pirate. Cuddy turns off the TV and takes the call.
Chase returns and Hadley tells him to get more clotting factor since Darrien is bleeding into her skull. Chase objects and says that they could lose their license, but Hadley insists that she can’t break her promise. When he tries to go past her, they fight and he finally knocks her to the floor and goes to get Darrien.
Cuddy arrives with Rachel to see House, and sends her daughter out of the room. House insists that it was minor surgery, not an emergency, and that he didn’t trust a surgeon given his past history with operations on his leg. He asks Cuddy to help him remove the last two tumors but she refuses, insisting he has to go to the hospital.
As Chase drives Hadley and Darrien to the hospital, he explains that he’ll fake the papers so the authorities don’t learn that Darrien was treated.
As Cuddy drives House to the hospital, she tells Rachel that he was being reckless. Cuddy accuses him of trying to find happiness by healing his leg, and won’t let him blame his recent unhappiness on their breakup.
As they drive, Hadley asks Darrien what she saw, and realizes that Darrien was a cop. Darrien concealed her previous profession in prison, and she killed a nineteen-year-old kid. After that, she started using drugs. Darrien goes into a coma and Chase speeds up, unwittingly driving past Cuddy. When House talks about the pirate cartoon, Cuddy realizes that he let Rachel watch it. She complains and House suggests there are more recent idiotic things he’s done that have priority.
Foreman finds Taub outside the strip club, and Taub says that he wants to make sure that Dina’s mole isn’t cancerous. He insists he wants to fulfill his oath as a doctor, but Foreman figures he wants to make himself suffer for getting a girl pregnant. Taub refuses to give him the keys and Foreman catches a cab.
As they run the MRI, Chase wonders if Hadley is so worried about keeping her promises. He figures that she doesn’t feel bad about killing her brother because she defends it as keeping a promise, so now she won’t break any promise. Hadley insists she saved her brother from pain, and then confirms there’s no bleed in Darrien’s brain. They realize that she has a fever, indicating infection, but it can’t be from the stabbing.
As they wait to admit House, Cuddy realizes that House is going into shock but he says that he’s fine and chats with Rachel about the cartoon. Cuddy takes Rachel with her as she goes to look for a nurse, and House’s phone rings. It’s Hadley and Chase, who want his opinion.
Taub starts to call Ruby but reconsiders.
Hadley tells House that Darrien was on interferon for the Hep-C, indicating a chronic case. House tells her to stop guessing, and they admit that the prison records are spotty. He then tells them to confirm when Darrien shot the boy, because that was when she started taking drugs and got the Hep-C. Cuddy and Rachel return with a nurse and House hangs up.
Taub starts to call Rachel but stops when he sees Dina come out. He approaches her and tries to explain he’s concerned about her mole, but she draws a gun on him and orders him down on his knees, his back to her. Dina refuses to let another guy hit on her but simply drives away.
As they check the records, Chase offers Hadley some ice for the bruise he inflicted earlier during their fight. She admits that he had to do it and that he was right about everything. Going back to the records, Hadley learns that Darrien had a different name and that the shooting took place in 2008. The prison wouldn’t have prescribed interferon for short-term Hep-C, so they conclude that she had a entamoeba in a parasitoma, and the knife wound opened up the parasitoma, releasing it into her blood and speeding up the liver damage. Metronidazole will cure her.
As House is prepared for the operation, he asks Cuddy in there to protect his interests and make sure the surgeon doesn’t cut more than he needs to. House wants Cuddy there to make sure that if the surgeon takes his leg, it’s necessary. Cuddy considers and House admits that he trusts her. After a moment, Cuddy goes in with him.
Darrien wakes up and Hadley tells her that she’ll recover. However, Darrien realizes that she’s under arrest and curses Hadley for breaking her promise. Hadley says that she had to and that whether Darrien forgives her or not, she knows she saved Darrien’s life.
As House sleeps after surgery, Rachel asks her mother if House will be okay. She wishes that House could come over and play, and Cuddy suggests that they write House a letter.
Taub comes to see Ruby at the hospital and explains about how he met a patient with cancer, and the patient had raised his children right and knew he was leaving the world a better place. He admits that he wanted to be like that patient, and wants to have the baby.
Chase approaches Hadley in the locker room. She insists that Darrien had to shoot the kid, but she destroyed her life trying to forget. Hadley worries that the same thing will happen to her. Chase suggests that she talk to someone who isn’t a therapist. She wonders how he can possibly know how to live with something like what she’s going through. Chase offers her coffee.
The team meets in the conference room and Taub and Hadley are both tired. As they look for a new case, Foreman realizes he had a call from House and wonders if their boss is in.
House wakes up and immediately checks to make sure he has his right leg. Cuddy and Rachel are gone and Wilson is at his bedside. Wilson reads the letter from Rachel, saying she hopes they can be friends again. House tries to get out of bed to urinate but can’t walk on his mangled leg. As Wilson helps him, he tells his friend that something has to change, and House admits that he knows.
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