Wilson prepares his 14-year-old leukemia patient, Nick, for a last-resort bone marrow transplant from his younger brother, Matty. With Nick's immune system completely wiped out from chemotherapy, Wilson is extremely cautious about keeping him healthy before the transplant. However, when Matty sneezes during a pre-op visit to his brother, Wilson knows that Matty is not healthy enough to donate. House and the team race to find out what is making Matty sick so that they can treat him quickly and allow him to donate healthy, uninfected bone marrow to his dying brother. With no other matching donors available, the team knows that Matty is their best shot at saving Nick's life, since giving Nick bone marrow from a partial-match donor could lead to an excruciating death if Nick's body rejected it. House decides they must purposefully make Matty sicker and use his developing symptoms as a method of narrowing the diagnosis field. As both brothers' conditions worsen and Nick has only days to live, the team must diagnose and treat Matty before it's too late for both brothers. Meanwhile, Foreman is haunted by his mistake that killed a patient just one week earlier, and House only wishes he could incur similar misfortune upon his new pet and nemesis, Hector.

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