Nolan asks who else House pissed off this week, and we go to an expensive house with gardeners outside mowing the lawn using a push mower. Wow, I haven't seen one of those since my dad had one when I was like 3 years old and we were apparently too poor for an engine lawn mower. House is at the home owner's front door offering him fifty dollars to get his pawned book back. The guy refuses, saying he knows the book is a "rare surgical text" in mint condition and worth thousands. House offers him two thousand dollars, only for the guy to make an assholish comment about how he was smart enough to know a good pawn shop find when he saw it, so he wins at life and House loses. And with that, he closes the door in House's face. Sometime later, House is sitting in his car. Alvie enters with the book that he stole from the rich asshole's house. He's so happy about his success that he does a quick freestyle rap. House interrupts to ask if anyone saw him. Alvie says the rich asshole (who is apparently a professor. One of those professors who makes like millions of dollars, I guess) totally saw him outside, but assumed he was one of the gardeners. House smiles at this, and they drive away.
Both House and Alvie go to House's office. Taub enters to report that they stuck a pacemaker in Sydney's heart to control her heart rate. "Hello!" Alvie says brightly. Taub just turns and looks at him, then says hello back, not all that surprised to see a random young guy hanging out in House's office. Taub continues that they found rapidly progressive cardiomyopathy in Sydney's heart, which means she doesn't have spongiform encephalopathy after all and whatever it is is attacking her body as well as her brain. Wow. Good thing the husband was there to refuse to allow them to cut out a piece of Sydney's brain, huh? Also, why is Taub in House's mind so much? Did Foreman and Hadley and Chase have the week off or is House just in love with Taub? Alvie just grins away until two officials walk into House's office looking for him. It's the INS, and they're here to deport him for missing his hearing. The official nods at House, and Alvie is heartbroken and betrayed. "You called them?" he asks. House doesn't answer. The INS take Alvie away. Taub decides to ask what's going on. House doesn't answer, probably because he's ashamed of himself. I guess he really held a grudge about that magenta ceiling.
The rest of the Cottages show up for work along with Taub the next morning and talk to House over the speaker phone about Sydney's condition. They're having trouble stabilizing her heart. Hadley diagnoses her with endocarditis. House, meanwhile, is speaking to them on his cell phone while he waits for Alvie's hearing to begin. Alvie is still furious with House and refuses to talk to him. He talks to House to tell him this, then waits one second before asking why House turned him in. House ignores him and suggests tuberculosis, because apparently Sydney's last name is Brontë. Both diagnoses are contingent on Sydney's running habit suppressing her immune system. Meanwhile, Alvie says he hates House and the court bailiff gives the room a "gentle reminder" that cell phone use is not permitted. House ignores him and tells the Cottages to treat Sydney for TB. The bailiff starts threatening to arrest House for contempt of court. Why doesn't House just tell him he's a doctor and this is actually an important phone call? House quickly tells the Cottages to get tested for TB since they've all been exposed to Sydney. As has House and Alvie and now everyone in the courthouse. Oops! Meanwhile, check out the people sitting behind House, all scandalized over his refusal to obey the bailiff! That was actually some good acting by the extras there. That one lady who put her hand over her mouth in shock especially.