House goes to see Cuddy about a court ordered brain stem biopsy, but she has something to show him in her office first. It's a trick! David Morse, now introduced properly as Michael Tritter, is there, waiting for his apology. Cuddy leaves them to talk things out. Tritter says that he'd rather beat the crap out of House than sue him, and House doesn't really care. I don't really, either, and I'm starting to have Vogler flashbacks. Tritter continues that House is a bully, and making him apologize would be humiliating for him and make him think twice before treating future patients like crap. Oh, give it a freaking rest, Michael Tritter! So he made you sit around for a while with a thermometer in your ass. Who cares? Is it really worth all this time and aggravation? It certainly isn't to House, who refuses to apologize and says that he only wishes he had left a bigger thermometer in Tritter's ass. I don't think he'd be able to fit it -- there's a sizable stick up Tritter's ass already.
Foreman and Chase tell House that Jeremy's brain is fine, but his intestines are rotting. Which means it's not sarcoidosis after all.
How could The Rich List be "the most anticipated game show of the year" if I've never heard of it until this commercial?
Tracy's brain is getting worse and Jeremy's intestines are falling apart. Chase says Jeremy's high levels of lactic acid point to ischemic bowels, which will have to be removed. Cameron guesses vasculitis was the cause of the ischemic bowels. Foreman says that they might be looking at two different diseases and an amazing coincidence. He guesses that Tracy has some disease I can't find on the internet and isn't important anyway since she doesn't have it. House agrees to treat Tracy for that and remove Jeremy's bowel, but doesn't seem very happy about it or convinced that they're right. It's always good to do major surgery on an already-sick patient when you aren't sure if it's necessary but have run out of options.
Foreman removes the dead bowel and biopsies it, only to find that the bowel isn't dead after all. They only assumed it was because of the high amounts of lactic acid in Jeremy's bloodwork. So they removed it for no reason. Oops! Guess the hospital will be getting sued after all. Sorry, Cuddy!
Foreman has the decency to look ashamed of this while House tells them to start over again and differentially diagnose Tracy and Jeremy anew. Chase wants to test for more STDs, but Foreman won't believe it. He's a super-romantic in this episode, and exposits that Tracy is Jeremy's only girlfriend ever and they grew up next door to each other. This gets House's attention. He asks why Jeremy and Tracy ran away when they were sixteen. Foreman says they were trying to escape Jeremy's evil pill-popping racist dad, only to end up in a hospital with one for a doctor. House wonders whether Jeremy's dad didn't want him to date black girls in general, or if it was this one black girl in particular. A black girl with beautiful green eyes. He thinks Tracy and Jeremy have hereditary angioedema, which causes edemas to form in various parts of the body, like Tracy's brainstem and throat and Jeremy's bowels. Chase points out that the disease is extremely rare, and the chances of two non-related people who have it growing up next to each other are very, very slim. House says those chances get much better if the two people are related, and points out that Tracy and Jeremy both have the same green eyes. Oh, no. Tracy and Jeremy are half-siblings, Tracy being the product of an affair her mother had with Jeremy's father. And Jeremy's father has hereditary angioedema and apparently decided not to tell anyone else about it. That's why he was always popping those pills. He also didn't want to tell anyone that Tracy was his daughter and chose to break Jeremy's arm for seeing her instead and letting everyone chalk that up to racism. But he wasn't a racist -- on the contrary, he loved black people. Unfortunately for Jeremy. And then he killed himself because he couldn't live with the guilt and didn't see fit to leave a revealing suicide note. House says they don't have time to test for this, so they should start treating Tracy and Jeremy and see what happens. No one seems too happy about House's diagnostic miracle, not even House. Wow. I'll tell you, I did not see the incest thing coming. Damn.