Returning from a medical conference, Dr. Cuddy and Dr. House board a Malaysia air flight to New Jersey. Cuddy complains that she can't justify some of the expenses House incurred, totaling $500. House tells her not to worry, because he downgraded her first class seat on the plane, making up the $500.
However, when another first class passenger becomes seriously ill, House decides to switch seats with Cuddy. But the case is so strange that she needs House's help. And also because it might be necessary to turn the plane around before it goes over the North Pole.
Meanwhile, back at Princeton-Plainsboro, Dr. Wilson and the team diagnose Fran (Jenny O'Hara), a 59-year-old woman who passed out before paying a prostitute, Robin (Meta Golding). Robin brings Fran to the hospital and remains concerned about Fran even after Dr. Wilson gives her permission to leave.
This episode contains examples of the following tropes:
- Actor Allusion: Dr. House, annoyed by a crying baby on an airplane, tells the mother to give the baby a sedative. Not the first time we've heard that from Hugh Laurie.
- Busman's Holiday: Dr. House just wants to relax on the flight home, but he and Dr. Cuddy wind up working on the diagnosis of a potential epidemic.
- Contamination Situation: Cuddy shows some of the same symptoms as the supposed epidemic's patient zero.
- "Eureka!" Moment: When having the patient held down for impromptu surgery, House notices that the pressure causes the patients convulsions to stop. A quick check of the patients wallet shows a receipt for SCUBA diving. The patient had the bends from improperly surfacing combined with the altitude of the plane.
- Hooker with a Heart of Gold: Robin, the prostitute hired by the patient, decides to stay with her throughout the whole ordeal - at first reluctantly, but then willingly.
- Suspiciously Similar Substitute: Not having his usual team, Dr. House instructs a blond boy to fake an Australian accent and agree with him no matter what he says, an Ambiguously Brown passenger to disagree with him, and a female passenger to be morally outraged, filling (what he perceives are) the roles of Chase, Foreman and Cameron respectively.
- Too Dumb to Live: House's patient, very nearly. He gave himself decompression sickness by going diving the same day he got on the plane, something even a SCUBA novice would be instructed not to do.
- Vomit Chain Reaction: Or as House puts it, "Monkey see, monkey barf". Healthy passengers start throwing up in response to patient zero, adding to the hysteria.
