Back in her office, Cuddy and Wilson are up to their typical conspiring ways. I think it's adorable that they still think their two heads together are better than House's one. Such optimism in these two, such hope. Wilson doesn't think Cuddy's plan will work, but she's sure House can't diagnose the patient in one day. "He needs a team," she maintains. Wilson points out that forcing House to hire a team because of a bet is not the way to make him truly see your point of view. The only way to do that is to have the exact same point of view House has.
House does seem to be missing his Cottages as he writes on the board and then asks three empty seats for their differential diagnoses. But there is someone there after all: "You talkin' to me?" a heretofore unseen janitor Travis Bickles.
We cut to the janitor seated at the conference table while House attempts to put his case in a language the janitor can understand. And that language is cleaning products. Meanwhile, I'm wondering if this is the Weird Night Janitor Who Wears His Pants Backwards I've heard so much about. I'm guessing it isn't, since this guy's pants appear to have been put on correctly, it's daytime, and House and the janitor don't seem to have the kind of familiarity I would expect. Disappointing! House asks Normal Day Janitor Who Wears His Pants Forwards why his floor buffer would get all overheated after the janitor's closet collapsed on it. "From stuff falling on it?" NDJWWHPF suggests. From this, House comes up with a differential diagnosis of brain damage leading to hypothalamic disregulation. Except...didn't that happen to Pool Addison Man last season? NDJWWHPF says that perhaps "stuff leaked in the holes, messin' it up." House considers whether the collapse caused multiple lacerations that became infected, possibly by a parasite or fungus. "Or maybe lupus," NDJWWHPF suddenly says, and I'm starting to think he's not a janitor at all, but some random fan from LiveJournal who wandered onto the set and started ad-libbing. Since when did lupus become the new vasculitis, anyway? I miss vasculitis. "My grandma has lupus," NDJWWHPF explains off of House's questioning look. For one second, House thought NDJWWHPF was Cameron. Then he saw the lack of vest and knew it was not. House says he'll run a lupus panel, then grabs his cane and says they're going to have to do the least pleasant part of his job. Surprisingly, it is not picking through feces, but meeting the patient's family face-to-face.
The patient's family turns out to be Boyfriend Ben and girlfriend's mom, a Sally Field look-alike, although I suspect her face looked much different before her extensive plastic surgery. It quickly becomes apparent that Boyfriend Ben knows a lot more about Girlfriend Megan than her mom does. House tells his assistant, "Dr. Buffer," to take down notes, and we see that the janitor is now wearing a white coat and a stethoscope and totally going along with this. Hey, wouldn't you? Cleaning stuff up sucks sometimes. This is a lot more fun. House immediately starts in with the making fun of the patient's stupid family, suggesting that her feeling sick before the collapse may have something to do with her being sick afterwards. Meanwhile, we see post-building Megan for the first time, and, as you can probably guess, being buried under six tons of concrete has not done good things for her face, which is all bruised and swollen with one eye appearing to be sewn shut. ["They will have to turn her bionic! To the secret government underground lab!" -- Miss Alli] Ben begs House to tell him his girlfriend will be okay, to which House says he doesn't even know if Ben will be okay. [He's a doctor, not a crystal ball! -- McCoy] Because someone has to, NDJWWHPF acts right and puts a comforting hand on Ben's shoulder. Gross. NDJWWHPF is so the Cameron. "We're gonna make her all better," he says. Yep.