The CSIs track a cannibalistic killer and discover he's not alone.
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The team takes on the case of Derrick (guest star Skylar Astin), a 19-year-old college student who had a mysterious nose bleed during cheerleading practice, and discovers that his health issues are likely both physiological and psychological. Possibly suffering from schizophrenia, Derrick claims to hear his deceased brother’s voice in his head. Meanwhile, Wilson gets advice from former colleague Thirteen (guest star Olivia Wilde) and Foreman tries a different approach with House.
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While Alicia wades through diplomatic loopholes to defend a Taiwanese national, Eli is approached by his ex-wife to vet her for a possible political campaign.
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The ZBZ house decides to throw a Great Gatsby party but must find a way around the representative's harsh rules. Rusty convinces Calvin to consider pledging Kappa Tau.
Rusty and Casey return to CRU but must contend with the backlash from Jen K's story, and deal with the fallout from their relationships. Meanwhile, Cappie and Rebecca must make a choice about their relationship.
On a windy, rainy night, Cappie is visited by a beautiful, mysterious girl named Destiny who turns out to be Patty the Fatty who loved Cappie obsessively since their days at camp. Over at the ZBZ house, Casey plans a slumber party to bond with the pledges but the night takes a drastic turn when Ashleigh reveals that a girl named Virginia hung herself in the house. Evan and Calvin, also braving the storm and lack of electricity, bond through the adventure of trying to kill the house rat.
When the Kappa Taus have trouble making the volcano for their legendary Mt. Vesuvius party work properly Rusty volunteers to make it happen. With the help of Dale and Jen K, a ZBZ pledge, Rusty is able to steal an outmoded atmospheric destabilizing module to plant inside the volcano for the eruption effect. Meanwhile, Casey and Evan are back on track and Evan introduces Casey to his parents over dinner. However, Rebecca makes an unexpected appearance and instantly bonds with Evan's parents leaving Casey to feel like an outsider of this blue-blood clan.
In the midst of the floor hockey tourney, Evan questions Casey's loyalty considering her brother and ex-boyfriend are both Kappas. Casey quells that suspicion by successfully caring out a plan to make the Kappas too hungover for their game against the Omega Chis. Rusty, desperate to play for the team but without a single athletic bone in his body, gets the help of Dale who suggests they take a scientific approach to the game. This comes in handy when, with all the brothers drunk, Cappie has no choice but to allow Rusty to play.
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