House finds Della and Hugo's father in his office. He knows the Evil Transplant Committee will never okay a second lung for Della and wants to tell her what the other options are. House refuses to name them, but Della's dad begs him, saying he'd do anything to save his daughter's life. House admits that they could get a lung and bone marrow from Hugo, and that this will cut Hugo's remaining life expectancy in half. And the parents only have one night to make this impossible decision before it'll be too late. Hugo, apparently, doesn't get a say in it at all.
Sad music plays as they spend the night fighting and crying. Taub goes to check on Della, who wants to know why her parents aren't in the room and why she saw them yelling and crying earlier. "They care about you a lot," Taub says. He thinks that'll tide her over, but Della is in the science club, and so she somehow puts it together that if her brother was a bone marrow match, then he could also donate a lung. She asks if that's what her parents are fighting over. Taub lies that it isn't, and then he walks away.
Meanwhile, the parents wonder how they'll be able to live with themselves no matter which choice they make. Suddenly, Chase and a handful of PPTH staffers rush past. Yes, Della disconnected herself from everything and took a walk down the stairs without anyone noticing until she collapsed on the landing. Taub explains that Della figured out what was going on and must have done this to die and spare her parents and her brother any more pain. Well, except the pain of losing their daughter and sister, although I guess Della either didn't think of that or just figured they'd be better off without her and with Hugo for five extra years and no guilt over having to choose between their kids.