House must fire one of his doctors at Vogler's insistence and leaves them wondering about it while dealing with a case. House and his team blame an adverse reaction to diet pills after an obese 10-year-old girl has a heart attack, but they ultimately uncover a much more deadly source for her illness. House examines a woman who won't accept surgery for a 30 lb. tumor because she wants to remain overweight.

While House and his team scramble to discover what's causing brain and kidney dysfunction in a pregnant woman, Vogler is on the warpath to get House fired after House's pharmaceutical speech. House determines the illness, but the woman and her husband struggle with an emotional and heartbreaking choice between her or her unborn child. Vogler calls for a vote of the Board of Directors to remove House, but when Wilson refuses to make the vote unanimous, Vogler threatens to take his money if the Board doesn't remove Wilson. Finally, Cuddy must take a stand against Vogler.