Dr. Wilson attempts to create a deal between Detective Tritter and Dr. House, but House stubbornly refuses, in large part because the deal involves House spending up to two months in rehabilitation, supplied only with low-strength pain medication. Eventually, Dr. Cuddy sides with Wilson and refuses House any Vicodin, causing him to detox, and removes him from his team's case: a 15-year-old girl suffering from a collapsed lung and anemia.

The patient, Abigail, and her mother, is considered to be suffering from cartilage-hair hypoplasia, a type of dwarfism. Abigail also presents with apparent liver cancer and diabetic ketoacidosis, among other things.

House picked up a prescription for pain meds from the hospital pharmacy, supposedly for a patient of Wilson's (it turns out the patient has recently died). Cuddy offers House Vicodin, asking him to come back to help with Abigail's diagnosis, and House refuses Cuddy's drugs, but takes on the case.

Abigail is eventually found to have a granuloma pressing against her pituitary gland, evidently causing her apparent "dwarfism", which points to Langerhans cell histiocytosis. These symptoms are addressed and Abigail is offered treatment, but she refuses on account of not wanting to "fade into the background." House questions Abigail's mother on whether the uniqueness of being "a freak" is worth the hardship. The mother later convinces the daughter to go through with the full treatment.

It's Christmas Eve, and Wilson invites House to spend time with real people, but he goes home instead. House leaves a Christmas message for his mother on the phone, then ends up overdosing on pain meds and alcohol. Wilson comes to check on him at his house, and discovers House on the floor next to a pool of vomit, pills included. Wilson leaves in disgust. House goes to Tritter to take up the deal, but Tritter turns him down, saying they have new evidence of House taking the drugs illegally from the hospital pharmacy.