The latest differential-diagnosis session takes place in Cuddy's office, perhaps in the hopes that a new location would yield some new results. Alfredo now needs a ventilator to breathe; Cameron -- sounding just a little pleased with herself that her theory about the fungal medicine being dangerous was correct -- adds that he also requires dialysis for those failing kidneys. House says that they're getting distracted by Alfie's "multi-system organ failure," and should focus on his hands and their tendency to change color. He wonders if the DIC theory is wrong, even though the blood tests indicate it. As the Magic School Bus Cam shows us, House voice-overs that, in endocarditis, the infected heart pumps out bacteria that inevitably works its way through the bloodstream, affecting other parts of the body like Alfie's right hand, kidneys, and left hand. It also explains the fever. And it has the added bonus of being the reason Alfie's kidneys failed, as opposed to those drugs, which makes Cameron wrong again. Cuddy says that totally works, except for the fact that Alfie already tested negative for endocarditis. But wait -- there is such a thing as culture-negative endocarditis that also causes pneumonia. No one knows what House is talking about, so he makes chicken sound effects as a hint. Chase figures out that he's talking about psittacosis, and discounts that immediately, since Alfie doesn't have a pet parrot. House orders doxycycline, the antibiotic used to treat psittacosis. Cuddy jumps up and says no way, since it will make Alfredo's clotting problem even worse. House says it will also save his left hand if administered right now. Cameron says that if House is wrong, Alfie will lose his remaining hand and his feet. House says that Alfie will also die, so no prob. But he does see that some more substantial evidence is needed here. He's off to find out what job lets a twelve-year-old sub for his sick brother.
House, followed by a resigned-looking Cuddy, enters Alfie's room and asks him where he works on Saturday nights. Alfie doesn't answer, because he's sleeping off his recent surgery. House goes to inject him with a stimulant, and Cuddy objects. So House asks Mama where her son works on Saturday nights...in fluent Spanish. Cuddy asks House why he didn't tell them that he spoke Spanish. House says it would have resulted in people talking to him. Mama says that Alfie doesn't work on Saturday nights. It's the only night off he has all week. House asks Cuddy to let him shoot Alfie up with the "talking juice," and she says she won't because Mama isn't necessarily lying just because she's not giving House the answer he wants. House explains that he overheard Manny and Alfie's IMPORTANT CONVERSATION about Manny's covering for Alfredo at work tonight. Dude, they're all at work on a Saturday? That's dedication. House asks Mama again what Alfie does on Saturday nights, and she says he hangs out with friends and goes dancing. House thinks he's "dancing with birds," and Kevin Costner springs from his couch and goes to call his agent until he realizes that he forgot his agent's phone number and his phone is dusty from disuse. Mama won't give up any more information, and House asks if he can shoot Mama up with the talking juice instead of Alfie. He can't, so he orders Cuddy to take the "Scooby gang" and look for Alfie's secret hideout, which is probably near his house. Because House mysteriously knows all about the ways of illegal cockfights, he tells Cuddy to "find somebody who looks like crap" and try to place a bet. Is he saying that Latinos look like crap, or is my racism-sensitivity radar all thrown out of whack by this episode? "Sayonara!" House screams at Mama as they leave.