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Co-workers Russ and Valerie bicker over meeting details when he throws up. Valerie tells her boss Russ has been drinking again. Valerie is suddenly overcome with a piercing sound in her ears. Foreman discusses Valerie’s case with the team, mentioning to House that she is hot, supposedly to convince House to take the case. House has the team meet in Wilson’s office. House ignores Foreman until he mentions Valerie’s husband is not as attractive and House is compelled to understand why. House thinks Valerie’s problems are related to her heart. House’s cell phone rings and he ignores the call.

Wilson finds House asleep on his couch in his office. Wilson wants to know who House is avoiding by staying in Wilson’s office. House tells Wilson he is avoiding Wibberly, a fellow student from med school. House switched their finals paper to get a better grade from the teacher. Wilson discovers in treatment House was required to write a letter of apology to someone he hurt so he sent Wibberly a letter. Wibberly is interested in meeting with House, who can’t be bothered with him.

Valerie’s co-worker Russ confronts Valerie in her hospital room, accusing her of an affair with him and of drugging him at the meeting so he would be fired. Valerie’s husband is startled by this news and Thirteen gets a bad vibe from Valerie.

The team thinks Russ poisoned Valerie but Thirteen disagrees. Foreman orders Thirteen to go ahead with the beta-blockers prescribed by House. House is seen in Cuddy’s office talking on his cell phone to the team while defacing Cuddy’s framed pictures of her boyfriend Lucas. Wibberly walks into the office, telling House Wilson told him he’d be there. While having coffee together House learns that Wibberly never became a doctor, his switch of papers led to Wibberly failing his final and dropping out of med school. Wibberly tells House he is a grocery bagger, making House feel even guilter than before.

Thirteen suggests Valerie undergo an MRI before receiving the beta-blockers. Thirteen shows Foreman the MRI reveals Valerie is not using the emotional part of her brain, revealing she is a psychopath. House, Thirteen and Foreman confront Valerie who pretends she is innocent but then admits she poisoned Russ to steal his ideas for work. Valerie admits she only married her husband for his money. Thirteen is appalled by her lack of conscience.

House knows there must be a connection between the psychopath and cardiac arrhythmia yet psychopathy is genetic and not a symptom. Foreman thinks Tertiary syphilis fits the symptoms. House tells Thirteen he is ruling out Wilson and Hashimoto’s diseases. Foreman tells House he needs to discipline Thirteen for not following his orders but House tells Foreman that is his job as her supervisor. Cuddy confronts House about her damaged photos, letting him know he cut up the last photo her father took of her. House feels remorse, a new feeling for him.

House, feeling guilty, decides to visit Wibberly at home. He discovers Wibberly is packing up his house, his bills for his father’s health care means he can’t pay his mortgage. Thirteen and Taub test Valerie for syphilis. Valerie threatens Thirteen if she tells her husband the truth about her she will have Thirteen fired. Thirteen moves Valerie’s arm to administer a test and Valerie’s arm is broken.

Tests reveal Valerie’s bones are brittle. Syphilis is ruled out so Foreman is leaning towards lymphoma. House orders radiotherapy treatment. House reprimands Thirteen and Foreman who continue to argue at work since they have broken up. Thirteen suggests to Valerie’s husband he check on her landscaping class to see if they used toxins, which will reveal Valerie was lying to her husband about attending classes. As House administers a radiotherapy session, Valerie goads him about being like her, without a conscience. When Valerie’s husband confronts her about her class, Valerie makes up another lie to cover her tracks. Valerie asks Cuddy to fire Thirteen or she will sue the hospital. Cuddy is not impressed with the threat but tells Valerie Thirteen is off Valerie’s case to placate her. Valerie calls the medical board and reports Thirteen. Thirteen confronts Valerie in front of her husband and Foreman, who tells Thirteen to leave the room. After a heated argument Foreman appologizes to Thirteen for firing her and hopes they can work together again.

After being paged Foreman rushes to Valerie’s room and finds her covered in blood. Valerie’s liver is failing and blood is spilling into her esophagus, she is rushed to the operating room. The team decides Valerie needs a liver transplant but cannot provide one without a diagnosis.

Wilson finds House writing a check to cover Wibberly’s mortgage. Wilson hammers House about apologizing to Cuddy, who was in love with House for years but instead House treated her badly. Wilson thinks it is easier for House to be kind to a stranger than to apologize to Cuddy, someone he really cares about.

Thirteen finds out Valerie’s estranged sister has been tested for a liver transplant. Thirteen discovers Valerie changed in personality during puberty after a horrific childhood with an abusive father. Thirteen realizes Valerie’s raw food diet include nuts which are high in copper and have awakened the dormant symptoms of Wilson’s disease in her. House and Thirteen test nail polish remover on Valerie’s finger and her nail turns blue, proving Valerie cannot process copper. House starts Valerie on Chelation therapy. Thirteen tells Valerie’s husband she may change with the therapy but chances are she will remain uncaring and continue to use him for his money. Valerie’s husband thinks his love is enough for the both of them.

House visits Wibberly to give him a check face-to-face. Wibberly refuses the check, telling House he got an A+ on the paper and didn’t drop out of med school, instead he became an orthopedic surgeon but ruined his career with a gambling problem. Wibberly thought House would still be a bastard and is surprised by his generosity, but says no to the check.

Valerie’s health improves with treatment and she will eventually be ready for a liver transplant. Thirteen watches as Valerie’s husband sits by her side but Valerie rejects him to drive him away from the marriage, as he walks away she begins to cry. Thirteen realizes Valerie is feeling remorse and her personality has changed for the good from the treatment. Thirteen seeks out Foreman to mend their relationship, helping him decipher Taub’s written notes for Foreman’s report.

House visits Cuddy’s office to apologize to her, but finds her talking with Lucas and leaves. House visits Wibberly’s home, dropping the check he wrote through the mail slot to help Wibberly pay his mortgage.