When Cuddy's handyman Alfredo, a young Latino and the sole provider for his family, falls from her roof and develops strange darkened pinkies, Cuddy joins the team in trying to figure out what's wrong with him. Despite everything the team tries, the whole hand becomes infected. As Cuddy struggles with worry and guilt, House and his team are forced to amputate Alfredo's hand so they have more time to diagnose the illness before it kills the patient. However, when Alfredo's other hand starts showing the same symptoms, the doctors look outside the hospital for answers. A trip to the young man's neighborhood helps them understand Alfredo's desire for a better life for his family, and provides a clue as to what might be causing his deadly illness.