The team takes on the case of a 16-year-old factory manager who fell ill when her lungs suddenly filled with fluid while at work. The teenager informs House and team that she is an emancipated minor living on her own and supporting herself, and has ever since her parents died. The team begins treatment for suspected heart problems, but when Kutner chooses to sympathize with the patient rather than follow House's directions, he and the team find out the hard way that the girl may not be telling them the truth. Meanwhile, Foreman asks for House's permission to work on a clinical trial and House rejects his proposal. In an effort to prove himself capable of working without House's supervision, Foreman takes on his own pediatric case; Jonah, a four-year-old with bloody vomit and diarrhea. When Jonah develops uncontrollable laughter, Foreman turns to Cameron and Chase for a consult. Chase suspects cancer of the stomach lining while Foreman think porphyria. When both tests come back negative, Foreman realizes that Jonah will die. He turns to House for help, but is rejected due to House's claim that Foreman's screw-ups are his own. Foreman goes back to Cameron and Chase for help, and they suggest that Jonah's mother or brother Evan had something to do with it. Foreman then thinks about Evan's protectiveness of Jonah and realizes Jonah has an iron overdose due to Evan telling him to take too many vitamins. After solving the case, Foreman tells House he is going to lead clinical trials. When House lets him, Foreman asks what changed, to which House responds, "Three days ago you asked me. Now you told me. You can't say no if it's not a question."