Drugged out punk rocker Ian is hanging out with his band in an alleyway behind a club, waiting to go on. Ian grabs a friend’s new guitar and starts dragging it on the round to break it in, and the friend hits him. The club owner calls them in, braking up the fight, but Ian starts to cough up blood then collapses.
A bored House is watching his favorite soap opera when Cuddy comes in and tells him it’s time to pick the two fellows for his team. House balks, until she tells him he’ll have to pay their standby salaries after the end of the week if he keeps them on. Even that doesn’t get him moving, so she threatens to take away his handicapped parking spot.
House leaps into action and goes down to the ER to see if Cameron has any patients for him with exotic ailments. She shows him Ian and says he’s a drug addict, but House thinks that his drug addiction symptoms are covering up something else. He meets in the lecture hall with the four remaining fellows (Amber, Taub, Thirteen, and Kuttner) and Foreman, and has them start working on the case. To get them going and to meet Cuddy’s deadline, he tells them whoever solves the case gets the job, and he’ll use a special point system to pick the person for the second slot. The fellows start throwing out exotic theories but Foreman insists that Ian is simply a drug addict. He also points out that Ian can only withstand one round of tests at a time due to his weakened auto-immune system. House lets Amber test her theory first.
House then drops in on Wilson, who has just discovered that he’s misdiagnosed a patient, McKenna, with cancer and gave the man three months to lift, when he didn’t have cancer at all. Meanwhile, Amber takes Ian to a bathroom to give a urine test but he sneaks a cigarette… while using an oxygen tank. The resulting explosion knocks Ian out and damages the restroom.
Wilson calls in McKenna and House drops in, going so far as to put on a lab coat to look like a doctor. McKenna is unhappy with the news, since he thought he was going to die so sold his house and bought a ticket for one last expensive vacation.
Since Foreman thinks House is wasting time as part of his newest game, House takes the fellows into hiding and runs a differential. Amber wants a new round of tests but Thirteen points out since her theory was wrong and she blew up a restroom, it’s time for someone else. House lets her continue but orders Ian on a nicotine patch to calm him down, and then is interested in Thirteen’s sudden interest and emotion over the case. Meanwhile, Chase talks to Foreman, who is staying close to Ian figuring House will show up there eventually.
They run a new round of tests on Ian but can’t get him to lay still. It turns out he tried to defy them by putting on a dozen nicotine patches. However, Taub notices that Ian has blackened fingertips indicating clotting, and proving Amber wrong.
Thirteen suggests malaria and House lets her do the next round of tests, while commenting on her sudden obsession with the case and her distaste for Ian. He wonders if she has a drug addiction in her own past but she just says she wants to help the patient whether she like him or not. She and Taub go to check up on Ian, only to discover he’s disappeared.
House has searched Wilson’s office and found his checkbook along with a blank liability form. Wilson isn’t thrilled about the search and House figures he’s going to pay off McKenna’s $6,000 even though Wilson made a good misdiagnosis. House then sends Taub to find Ian and gets on Thirteen’s case about her feelings for Ian, but she denies anything special is going on.
Taub and Thirteen find Ian in Pediatrics, wearing a makeshift cape and entertaining the children. He collapses and the get him back to bed. Meanwhile, Cuddy demands House choose his new team, but he surprises her by asking for her recommendation. She goes with Taub, who will stand up to House, and Kuttner who is similar to House. The fellows arrive and Cuddy slips out, and they reveal that tests have confirmed Ian doesn’t have malaria. Bad blood fragments in his circulatory system brought on his collapse, but House quickly determines that Ian was sharing a drug needle with one of his friends, and their blood got mixed.
House chooses Kuttner to run the next round of tests, but Amber figures Kuttner doesn’t have a theory and is just tossing something out so he can run tests and come up with something. House is impressed with her and docks Kuttner some points. He then talks to Ian who is more interested in people liking his music then trying to save his life.
McKenna come back in but refuses to accept Wilson’s check, insisting that Wilson ruined his life by taking away hope and then restoring it. He tears up the check and goes to get a lawyer.
It’s now Taub’s turn to theorize and he asks for a MRA to see if a blood vessel has wrapped around Ian’s trachea, causing the respiratory distress. Ian still can’t stay still so they go to Chase to have him do surgery on Ian’s heart, letting them see it directly. House asks Chase who he should hire, and when Chase balks, Taub blackmails him by noting that if he refuses the surgery request, it’ll look like he’s refusing to get revenge for being fired. Chase, impressed, tells House to hire Taub as well as Amber, and then goes ahead with the surgery. However, they find nothing and Ian’s condition gets worse.
A desperate House immediately fires Thirteen and Kuttner, and they start tossing out theories under pressure. They finally come up with a contaminated drug theory that House likes, so he keeps them on… for now. Amber tries to get the name of Ian’s drug dealer but he refuses, and comments on how unhappy she is.
House is listening to Ian’s (bad) early recordings when Wilson comes in. Wilson figures House is trying to control everyone to avoid pain, while House accuses him of trying to solve everyone’s pain. Kuttner comes in to tell them Amber has had no luck, and notes that Ian works with abandoned kids at a care center.
House finally figure sit out: he takes the fellows to Cuddy and tells them that all their theories contributed to the case, even though they were all wrong. Ian was exposed to measles when working with the abandoned kids, but his immune system is shot so now he’s dying. He asks for a brain biopsy but Cuddy refuses to authorize it without confirmed neurological symptoms. Amber points out possible uncontrollable swallowing and House seizes on it. Cuddy says they need to provoke a seizure to confirm so House uses Ian’s lousy music to set him off. Once they confirm the neurological symptoms, they do the biopsy and put him on steroids.
It’s time for the final election. House meets with the fellows and has Amber stand up. He admits she’s great at playing the game… but if she’s working for him, there’ll be times when she has to lose to him. He fires her, then announce that he’s firing Amber as well, even though he’d keep her if he could have a third choice.
Amber goes to see Ian and admits she’s unhappy and wishes she didn’t care, just like Ian doesn’t care.
Cuddy is unhappy House chose Kuttner and Taub: she only recommended them figuring he’d do the exact opposite. When she insists he needs to hire one woman, she ends up approving Thirteen’s hiring as well. As she leaves, she realizes House has played her all along and figured she’d give him his third choice. House just smirks.
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