House takes this week's case because the patient, who has an earache, is a hot woman married to an ugly man. The case becomes interesting when Hadley realizes the woman, Valerie, is a psychopath, incapable of feeling empathy or emotions. When Valerie's liver starts to fail, Hadley meets her sister who comes in to test as a donor because she, unlike Valerie, has feelings and just can't let her sister die, even though she knows the world would be better off without her. She also reveals that Valerie wasn't always like this: she used to care about other people until she hit her teen years and became cold, which the sister always assumed was a product of their alcoholic father's abuse. With the new symptom of psychopathy, House comes up with the correct diagnosis of Wilson's disease. Wilson's disease should not be confused with Dr. Wilson's disease, in which a useless but well-meaning cancer doctor makes his best friend feel really bad about people he's screwed over, both long ago and during this episode. House proves that he is capable of feeling empathy when he makes amends with a med school classmate he swapped papers with, but finds it much more difficult to apologize to Cuddy for ruining an irreplaceable picture taken by her dead dad. Hopefully, it won't take him as long as it took Foreman to apologize to Hadley for firing her, which he only does when it becomes clear that issues leftover from their failed relationship are affecting their ability to work together.
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We open at one of those fancy private jetports, where a trio of businesspeople are arguing because one of them didn't get some slides done for the Big Boss Executive, who is on his way to a meeting empty-handed. A woman in an evil red powersuit defends herself, saying she sent the other guy, who is clearly a schmuck, an email telling him to do the slides. She shows it to the executive and then the schmuck, named Russ, who has trouble seeing it on her Blackberry because he's having Ominous Vision Problems. "I never got this," he slurs. The executive asks if he's drunk. "I'm not drunk!" he says drunkenly, then barfs. "I'm not drunk!" he slurs one more time as he run/staggers away. Here's a tip: if you ever are drunk at work and someone calls you out on it, don't defend yourself while sounding and looking really, really drunk. Also, nice try at the Patient of the Week fake-out, writers, but I already saw in the previews that the patient is a woman and therefore not Russ, so I was not fooled. The woman volunteers to whip up some slides for her boss ASAP while also getting paper towels for the barf on his shoes, but screams and clutches her ears in pain before she can make it inside the airport. Where do those people work? Drama, Inc.?
The Cottages meet in Wilson's office (which we know immediately by the presence of the Ordinary People movie poster on the wall, because who doesn't want to display a poster for a movie about a family that falls apart in the wake of a son's death and the other's suicide attempt at work? Maybe Wilson is just a huge Mary Tyler Moore fan) to discuss their newest patient, Valerie, who's been to six doctors about her severe intermittent ear pain thus far with no luck. House finds her case boring, but the only other choice is a 14-year-old boy with joint pain and excess hair growth, and no one wants that. He takes Valerie's case once Foreman mentions that she's "really hot" with a husband who is "really not." And since he works as a social worker (apparently they put your spouse's job in your medical history now?), he isn't rich, either. Hadley says she might just be one of those people who can love someone based on something besides his appearance and personal wealth, such as his personality, but since her co-workers are both shallow and men, they refuse to believe this is possible. Chase suggests Valerie's recent diet change to raw foods might have something to do with her earaches, because that fact will be important later, but House thinks Valerie's real problem is her heart, and an arrhythmia is presenting as ear pain. He sends the Cottages off to deal with that as his phone rings with an uncharacteristic normal ring and not, say, a Salt-N-Pepa classic hit or the theme to Super Mario Brothers. That, and the fact that he avoids answering it, makes the Cottages suspicious. All we find out is that it's from someone called "Wibberly."