The episode opens with Hannah lying in bed at 3 A.M., wide awake, with her partner Max. Max asks Hannah if she cannot sleep again. Hannah says she's fine and goes downstairs for a glass of wine. Max falls asleep again and wakes up in the morning. She finds Hannah in the bathroom banging her head against the wall with an empty bottle of sleeping pills, bleeding. It is revealed that she has not slept for about ten days.
Hannah is discovered to be sleeping for very short bursts of only ten seconds or so, so short that her brain does not remember that she has slept at all. Her symptoms develop rapidly: she starts bleeding through her rectum and later her nose. House at first thinks it's Wegener's granulomatosis. Hannah then develops massive internal bleeding in her abdomen, and tests show she has acute liver failure and would need a transplant, but since there is no diagnosis of the underlying condition, this would not be granted. Max—apparently unaware that Hannah was planning to end their relationship—offers to donate half of her liver to buy more time. Cameron wants to warn Max about this, but House refuses to let her, and asks Cuddy to advise Max before the surgery. At the end of the episode Hannah is diagnosed with the bubonic plague, probably contracted through fleas from her dog. Finally it is revealed that Max knew that Hannah was planning to leave her, and the transplant was a tactic to ensure she would not because of her gratitude. The episode ends satirically with House fast asleep in his chair.
A subplot involves Cameron writing an academic article about the procedure used in an earlier episode and waiting for House's approval for the article for months. In that time, Foreman also wrote a similar article and House approved it first. When Cameron tries to apologize and requests one in return, Foreman coldly tells her that they are colleagues—not friends—and that he does not owe her an apology.
Another subplot, in the clinic, involves a young Chinese American girl, Anne Ling (Julia Ling), who wants birth control pills but, afraid to ask for them outright, seeks them for her elderly mother (Alice Lo) instead, who only has a cold. When she first comes in, House first says she has "SAC"—stupid American child. He gives her prescriptions for cold medication and birth control, telling her to go to a free clinic when she needs more of the latter. The girl comes back later with her mother, who says her breasts are bigger. House, dumbfounded, asks how the girl could mix up the two prescriptions. In Mandarin, the girl tells her mother House prescribed the wrong medicine, which he understands and corrects. He then tells the mother "Congratulations! You're going to be a grandmother!" (in Mandarin) then leaves.