It's snowing in Baltimore, thanks to the presence of Stacy the Ice Queen, who brings freezing temperatures and frozen faces wherever she goes. She's here to advise House for his trip to meet with some Medicaid billing review officer guy, even though she's supposed to be a constitutional lawyer and you wouldn't think this kind of thing would be her specialty. ["Which returns us to the question of why a constitutional lawyer would be a hospital's house counsel, and the fact that she wouldn't." -- Wing Chun] The billing guy enters the room, and Stacy manages to smile in order to ingratiate them to him, while House refuses to stand and shake the guy's hand in favor of playing with his cane like an angry little boy in time-out.
The Cottages attempt to do a differential diagnosis without their fearless leader. Foreman thinks they should concentrate on something that would make Fletch collapse and cause the aphasia, like a stroke, while Chase the Doubter wonders why they're taking Greta's word for it that Fletch collapsed when thirty other witnesses say he simply tripped. Surely Greta is LYING to them to try to cover her ass in case Fletch sues her for having brain-scrambling office equipment. Cameron makes tea and tries to be agreeable. Chase decides that they should test Fletch for drugs, and goes on his merry way to do that until Foreman calls him back, saying that they aren't done with the differential. "You're not my boss," Chase snots. Foreman says that he's House's boss, and that House is Chase's boss, so there you go. Chase protests that Foreman supposed to supervise House, not them, and Cameron gets her dig in with a line about how Foreman's there to make sure House doesn't do anything crazy that will save a patient's life. Foreman does a double take at her uncharacteristic sassiness, and seems dismayed to have lost someone he thought of as an ally in this argument. "Someone has to be in charge," he protests. Cameron, who has apparently never had to endure the frustration of working on a group project during her school days, thinks they should be able to have a "discussion among peers." Cameron also probably thinks that the problems in the Middle East can be resolved with hugs.
Over in distant Baltimore, Medicaid Guy has a problem with House's prescription of Viagra for someone with a heart condition, especially since said patient is a woman who I'm guessing is not having a problem with erectile dysfunction. House explains that Patient Dolores couldn't take nitroglycerin, so he prescribed the Viagra for its vasodilating properties, which he's sure Medicaid Guy is more than familiar with, since House thinks it's smart to insult the manhood of the guy who could do some bad things to House's ability to practice medicine. House says he'd be willing to pay for the pills himself if Medicaid won't cover off-label drug usage, and now he's in trouble for trying to bribe the guy. Stacy tries a different tack, appealing to Medicaid Guy's upcoming retirement and to his own personal feelings about the faults of the Medicaid system. House is both shocked and confused as to how and why someone would try to catch flies with honey rather than cane varnish, but goes along with it.