A teenage girl who is impossibly devoted her brother and determined to live the life he can't due to his congenital muscular dystrophy collapses and is sent to PPTH. Unfortunately for her, she's under the care of the newly-tamed House, who is unable to stand up to Cuddy now that they're dating and thus won't perform any risky tests to diagnose his new patient. She goes from bad to worse, her kidneys failing and lungs bleeding. She refuses to let her doctors give her a marrow transplant from her brother because she thinks he has enough problems, and that mentality ultimately puts her at death's door, as she didn't tell her doctors or anyone about the cold-like symptoms she's been experiencing for the past year because she didn't think it was right to complain about not feeling well when her brother had it so much worse.
With this new information, House is able to diagnose her with sickle cell trait, but it's too late to save her life with anything except a partial lung donation from her brother -- which would then cut his life short. Cuddy orders House not to tell the parents about this option, but he does anyway, leaving them to make what is basically an impossible decision. Of course, they can't, which annoys House so much that he tells them off and then gets in a big fight with Cuddy about it, which the patient's brother overhears. He agrees to donate part of his lung to his sister and then convinces her to accept it, thus making the decision for everyone and showing House and Cuddy that their new relationship will only work if they're as honest with each other about it as they are with the Cottages, Wilson, and the HR guy.
House loves to play with cameras in its POTW opening, so this time we get a skateboard wheel cam as we follow a girl all over an indoor skateboard park as she performs for an adoring crowd, most of whom appear to be wheelchair-bound. Well, that's either cruel to the wheelchair people or a harsh warning to the skateboarders of what could happen to them if they don't land their tricks right. One guy says to another that his sister kicks ass. The proud brother brags that his sister even won in the boys division. With that, the girl, Della, walks up and offers to take the wheelchair crowd out for a spin. They all want to go, but she lets her brother go first. I don't know why she even asked for volunteers, then. She pushes him out and over various ramps. Their parents watch, and Della's mother is totally that chick from the Progressive commercials. Too bad I switched from Progressive to State Farm after finding out that they cost a lot less and provided better coverage. Progressive Flo is better than State Farm's smug guy. Suddenly, Della just lets go of her brother's wheelchair and he's out there on his own. Ah, that's more like the asshole siblings of the real world. Oh, but it turns out that she didn't do it on purpose as she collapses.
House waits for Cuddy to arrive in the Fox lot parking garage. He holds her hand as they walk to the elevator, and Cuddy says, while letting go of House's hand, that she's planning to inform HR about their relationship today. BORING. Now it's no fun at all. She asks House not to tell anyone about it until after they've talked to HR. House responds by grabbing her ass. "I just don't want our relationship affecting our jobs. Or the other way around," she says. Yes, I'm sure that'll take care of things. Cuddy has known House for years and is in love with him, so she knows very well that House always does what people tell him. They enter PPTH, and House makes a big deal out of pretending that he has no idea what Cuddy did over the weekend. Cuddy ignores him and hands him a new casefile. House accepts it immediately. Cuddy again begs him to keep his mouth shut about them until this afternoon's HR meeting, which promises to be awesome. House seems sincere when he says he will.
Cut to the meeting room. "I'm seeing Cuddy!" House cries to his Cottages (sans Hadley, for she is GONE! for now, but plus Wilson, just because). He then clarifies that she's usually naked when he does see her, and that she has a big ass. Wilson declares this untrue and leaves. The Cottages seem to believe House, though, and he changes the subject to their new patient and her heart arrhythmia. Taub changes it back to House's new girlfriend and what a bad idea this is. Foreman's opinion is that this is good and a long time coming. Chase concentrates on the patient. "In favor, indignant, indifferent," House labels the Cottages, at which point he notices that Hadley is missing. The Cottages inform him that she took a leave of absence and has disappeared off the face of the earth. House shrugs and says they'll just have to "wait" and see what happens with her. I agree. Now let us no longer mention her. He asks for a differential. Chase, the only person who was paying any attention to the case anyway, suggests that Della could have a late-onset form of the severe congenital muscular dystrophy her brother suffers from. House dismisses it, saying it wouldn't show up this suddenly. Foreman and Taub just want to know why House doesn't seem as curious about Hadley as they are. They think he knows something about her that they don't, but House claims he just wants a diagnosis. Chase speaks up again, suggesting something called long QT syndrome, which they can prove by frightening her and triggering another heart arrhythmia.