Mikey seems fine until his lung collapses. House says it is caused by bacterial problems, and Chase starts Mikey on ECMO. When the treatment appears to be working, he returns to Kara and finds her attempting to smother Mikey. Kara says she is hearing voices, which is what led to her trying to kill her child. The baby eventually dies from the smothering attempt.

House starts to think that both Kara and Mikey had the same problem, so he directs Chase to autopsy Mikey. Chase discovers that the baby has flattened intestinal villus, which causes House and Wilson to think that both Kara and Mikey have celiac disease, an autoimmune disorder that makes the patient unable to process gluten, a protein found in many grains. Since untreated celiac disease causes malabsorption, Kara's various problems – the seizure and her mental issues chief among them – are due to her having a severe lack of niacin in her body. Mikey was unable to get better in the hospital since the medication he was being given for what was thought to be a bacterial infection contained gluten.

Celiac also made Kara more susceptible to stomach cancer, leaving her with MALT lymphoma, which explains her vomiting blood in the hospital. Neither House nor Wilson is successful in convincing her to receive treatment, and the two conclude that she wishes to die due to what she has done to her son.

In the show's sub-plot, House and Wilson try to find out why Cuddy asked Wilson to have dinner with her. House buys her trash from a janitor to investigate and finds a box of red clover, a herb that is used by some cancer patients. Since Wilson is an oncologist, House believes the date is a medical consult. Wilson, however, runs a PCR test on Cuddy's spoon and finds that she is negative for all cancer markers. House notices that her estrogen is unusually high and realizes that the red clover is being used as a booster for fertility. House keeps this a secret, telling Wilson that Cuddy had some skin lesions.

(Recap adapted from Wikipedia's.)

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