In the operating room, Foreman tells Chase to administer a treatment that, while not so good for the baby, will help Naomi. Then Chase uses the little grabby-claw thing to grab and remove the clot, in a shot that may be recycled from the last time they did this. House enters, all dressed for the sanitary environment in a gown and gloves, showing that there is at least one hospital rule he'll follow. Suddenly, Naomi starts to decline. House lifts her blanket to reveal that the left side of Naomi's belly is purple. She's bleeding internally, and those blood-thinning drugs they gave her for the clot aren't going to do that any favors. House tells them to keep Naomi stable while he talks to her husband.
In the hall, House gives the Sean the bad news: Naomi is bleeding internally, and they can't stop it. Sean has to consent to a C-section, which will probably kill his wife but keep their baby alive. Since Naomi's almost definitely going to die either way, they might as well make the best of it and save the kid. Sean is so upset that he drops his coffee. House grabs his arms, addresses him by his first name (which makes me think that House only pretends not to know the names of his patients, or only bothers to make the effort to do so when it's absolutely necessary), and tells him to settle down so that he can make the decision. Sean cries that Naomi makes all the decisions in their relationship. "This decision is easy," House says. Sure, Sean will be responsible for agreeing to a procedure that finished off his wife, but he'll also be responsible for agreeing to a procedure that saved their baby, which is what Naomi would have wanted. Sean agrees to the C-section, and House leaves him. I love these glimpses of the human side of House. It shows that he's capable of being sympathetic and nice when it's necessary to make the effort. It's just a lot less necessary to him than it is to almost everyone else on the planet.
The baby is removed and brought to its own little treatment table, where Chase works on getting him breathing. Meanwhile, Naomi goes into v-fib. They bust out the defibrillators, and Chase goes to get a tube to intubate the baby. The doctors zap Naomi, to no effect, and then, without medical assistance from Chase, her baby starts to cry over the sound of her monitor flatlining. Foreman watches, devastated and helpless.
House sits on a bench, resting his head on his cane handle. Cuddy comes around the corner and House says that they need to talk. Cuddy says that she's late to the board meeting, and that she doesn't want to hear anything from House about how she should save his job. House says that this is not about that; it's about a patient. Cuddy doesn't want to argue with House about letting Naomi into that drug trial, to which House says he's more focused on his living patients right now. Cuddy didn't know about poor Naomi's death that, by the way, probably wouldn't have happened if her first C-section wasn't cancelled, and stops short at the news. House hands her Olive the Vegan Baby's CT scans, which show that her weight loss was not due to the raw baby diet, but to DiGeorge syndrome, which caused Olive's thymus gland to whither away, explaining the weight loss and the poor immunity system that brought her to House in the first place. House tells Cuddy that the test that confirms this will be coming back soon, and that they should put Olive on immunoglobulin replacement therapy when it does. He won't be involved with any of that, though, since he assumes he'll be losing his job within the next ten minutes. He limps away. Cuddy watches him and sighs sadly, because losing $100 million is not fun.