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.
Taub and Foreman head down to scare Della to death, with Foreman muttering about how this is a very extreme way to prove a diagnosis and Taub griping about how it's not as crazy as House sleeping with Cuddy. No, actually, I think trying to kill a patient is crazier. Sorry, Taub, but you're wrong. Taub says he's so against House and Cuddy because there's no way it will work and then House will be worse to them than ever. With that, he gets all creative and decides to shove some fireworks under a food tray and wheel it into Della's room. If you're going to kill someone by scaring them, you might as well go all-out.
House heads for Wilson's office, determined to make him believe that he's dating Cuddy. He doesn't get far before Cuddy walks in, saying "you told everybody, didn't you?" What? How does she know? Taub probably told on him. She's there to collect House for their HR appointment. House uses this as proof that they're in a relationship, but Wilson still isn't buying it, pointing out that House has to go to HR all the time for his various acts of inappropriate assholishness about the hospital. House leans in to kiss Cuddy, who pulls back and puts a hand up. Wilson is not convinced. "One peck, just enough to arouse him a little," House asks. Wilson stammers something about how he is not turned on by House and Cuddy being together, but House says he was actually talking about his penis. Ultimately, Cuddy strikes a deal with House that if she confirms their relationship to Wilson, he'll come to HR with her. "It's true," she then tells Wilson. He's skeptical. She kisses House on the lips. "I've been more passionate with my great aunt," Wilson shrugs. How long has he known House and he still sets himself up like that? Idiot. "Great Aunt Mabel?? Up high!" House says, offering a hand for Wilson to high-five. Cuddy offers a hand, too, placing it directly on House's crotch. Wilson looks at the hand, and then Cuddy. Once his shock wears off, I'm sure it will turn into disappointment followed by jealousy. "Are we done here?" Cuddy asks. Wilson gives her a slight nod, and she removes the hand and leaves. "I think you straightened out my limp a little!" House calls after her, so very pleased with himself.
They meet with Ernest Griffin, the director of human resources who needs his own web series at some point. He asks the new couple to describe the nature of their relationship. House compares it to insects that eat each other's heads after mating. Ernest takes some notes. Ernest also has a bunch of cardboard boxes stacked behind him that are no doubt full of notes all about House. In fact, House probably keeps him employed at PPTH. Which is good, because if anyone were to take a good look at Ernest's performance, they'd see that he really sucks at his job, both for being unable to deal with House and for hiring thieving sociopaths to work in the pharmacy. "It's a sexual relationship," Cuddy explains. "I believe that I can still supervise Dr. House effectively," she says. HA HA HA! She's never been able to supervise House effectively. Ernest says they want to make sure this doesn't become a liability, which House takes as an invitation to discuss whether or not Cuddy gives blowjobs. Ernest takes some more notes, than hands them "love contracts" to sign. House says something about crotchless undies. Ernest takes more notes. Cuddy assures Ernest that she won't be giving House any raises or promotions, and that there are no ongoing issues with House's current case. House stupidly speaks up to say they've figured out that Della has long QT and are about to scare her to death to confirm it. "No, we're not," Cuddy says, shooting him an icy glare. "Okay, no, we're not," House agrees.
Out in the hallway, Cuddy says she knows House is still going to try the scare test, even though Della isn't sick enough for something so extreme (so when Della is much sicker, that's the best time to stop her heart? Okay) and there are plenty of safer tests that will prove the diagnosis just as well. "Fair point," House says; "we're not doing the scare test." That was way too easy, so Cuddy doesn't believe him. To prove it, House calls Taub on speakerphone and tells him to cancel the scare test and do something else. Taub is livid, saying those other tests aren't as effective. I just thi