The Tyrant (House)

Plot

The team treats a brutal African dictator named Dibala (James Earl Jones) who has fallen ill. The dictator had made threats of ethnic cleansing against an ethnic minority, the Sitibi, and the team deals with ethical issues of treating a potential mass murderer.

The episode features an African man seen to be persuading Chase to not save Dibala. Later he dresses as a nurse and tries to enter Dibala's room. He's attacked by Dibala's guards. Chase finds out that Dibala forced this man to rape and murder a woman, and the man tells Chase that Dibala will do this to all the Sitibi. Chase is more curious than others and confronts Dibala, who eventually reveals his plans to kill off the ethnic minority. Dibala also mentions his youngest son is studying in Princeton and hasn't spoken to him in years because of what he reads in the papers about Dibala.

Since Taub has resigned and Thirteen was fired, Cuddy gets Chase and Cameron to help Foreman. They first consider dioxin poisoning from an assassination attempt and start Dibala on olestra. Afterwards, Dibala has a heart attack and runs a fever. House suggests Lassa fever, and Dibala is started on ribavirin. Dibala brings in a lady called Ama, claiming his Health Minister advised that blood plasma from one with antibodies for Lassa fever is more effective than ribavirin, and wants the team to use her blood. She insists they let her do this. Cameron suspects she is being threatened, and Cuddy says that if she is, she'd rather have a prick on her conscience than the death of Ama's family members, so Cuddy tells the team to use Ama's blood.

Dibala's right eye becomes bloody, a result of an enlarged lymph node which blocked the retinal vein. Foreman suggests lymphoma. They do a lymph node biopsy which comes back negative. Dibala also develops lack of short-term memory, spikes a fever and has nodules in his fingers. House thinks it's scleroderma. Cameron doesn't care enough to give an opinion, and Chase and Foreman think it's blastomycosis, so they start him on amphotericin B. Dibala's colonel, Ntiba, asks Cameron if Dibala is capable of thinking clearly. She replies that he definitely is not right now. She adds that neurons don't grow back and Dibala is already in his decline. She questions the colonel as to whether he can ever be sure if the commands Dibala from now on aren't just delusions of a sick, mad, dying old man.

While giving Dibala the amphotericin B, Dibala grabs her hand and says that if she inserts an air bubble into his IV, he'll have another heart attack. He confronts her about what she told Colonel Ntiba, and says she was putting a gun in Ntiba's hand. Now, he states, the gun is in her hand, and he tells her to pull the trigger if she wants him dead, but notes that it's not so easy to do it as to let someone else do it. After a moment, Cameron injects the amphotericin and Dibala is fine. Chase swears to kick Dibala out onto the street if he touches Cameron again. Dibala says he showed her her true character, saying she's too weak to act on her beliefs. Chase confronts him about his planned genocide of the Sitibi. Dibala says, 'Whatever it takes to protect my country!' After this, Cameron decides to take a side, and asks Chase for a blood test to confirm scleroderma.

The blood test hints towards scleroderma, so Foreman switches Dibala to steroids. Dibala eventually dies from severe bleeding into his lungs. Foreman finds a piece of paper that shows Chase had signed into the morgue at 9.45am - right before he did the blood test on Dibala. He realizes Chase faked the results of test with the blood of a 70-year-old woman, to cause the team to treat incorrectly and kill the dictator and confronts him about this. Chase says there is now a chance for peace and tells Foreman that if the police are to come for him, to warn him so he can first explain to Cameron.

The subplot involves Wilson, who tries to make amends with a difficult neighbor. House is staying with Wilson and his curiosity and meddling leads him to confront the neighbor and look into his apartment. He finds that the neighbor is a wounded veteran who lost an arm in Vietnam; However Houses further investigations lead him to discover the neighbor is Canadian. The neighbor's anger is derived from his pain, and his pain is due to a psychosomatic attachment to a phantom limb. House dismisses his veteran status as Canada was not combatively involved in Vietnam but the neighbor points out historically Canada did send troops to Vietnam in 1973 to enforce the peace process where he struck a land mine saving a child. House solves the dispute with Wilson's neighbor by kidnapping him and forcing him to undergo V.S. Ramachandran's Mirror box therapy, curing his phantom pains in his amputated hand. The neighbor is extremely happy and thanks House. Wilson finds the neighbor has withdrawn all accusations and is allowing Wilson to do things he had been very much against. Wilson wonders what House did, and House says he was nice. Wilson doesn't really believe him, but House merely asks, 'Do you really want to know?' Wilson says he'll give House the benefit of the doubt.

Meanwhile, Thirteen breaks up with Foreman, saying he wanted to do it to her but didn't have the guts and therefore fired her instead. He insists this isn't true and asks her to dinner. She initially refuses, but later accepts when she finds that Foreman got her a job at Princeton-General. She asks him why he didn't just step down instead of firing her, and asks him if he would do that instead if he could turn back time. Foreman insists he made the right choice, so Thirteen leaves.

The episode ends with House and Wilson watching TV, and they shout 'Oh!' together when the alligator eats a frog. Dibala's son arrives from Princeton and is shown crying over the dictator's dead body. Chase goes home and lies down in bed next to Cameron, very clearly feeling guilty. Foreman is seen burning the records that showed that Chase had accessed the morgue without a valid reason. These records incriminated him of faking the blood test.