House M.D. Episode 4.07 Ugly

A young girl screams on a train platform when she sees teenager Kenny Arnold's grossly deformed face. Kenny's father, Joe intervenes. They walk out of the station, followed by a documentary film crew. They are on their way to Princeton-Plainsboro Hospital for Kenny's long-awaited cranial reconstruction surgery.

The film crew tracks Dr. Chase in the operating room as he preps Kenny for a facial bipartition. Kenny goes into cardiac arrest on the table. Cuddy, Chase and House are filmed discussing the case. Until they can locate the cause of the boy's heart problem, the reconstructive surgery must wait.

The film crew must have full access to the doctors because they are paying for Kenny's surgery. Cuddy thinks that this documentary will bring positive publicity to the hospital. House is concerned that the Fellows will be afraid to say the wrong thing on camera.

Dr. Terzi, the CIA doctor that House hired, is among the Fellows in the lecture hall. Amber harps on Terzi. House enters with the camera crew and they all walk down to a radiology room. Yet there is no metal allowed inside because of the magnetism so he is allowed to ditch the camera crew. House and the Fellows brainstorm about the case while an MRI is performed on a patient. Cole suggests that Kenny is using drugs. Discoloration of skin around his nose indicates huffing Freon. House orders a Nuclear Study to see if there is scarring on the heart. Terzi asks House if he definitely hired her. She gave up her job to be here.

House voices his concern to Wilson. He feels like he made a mistake about Terzi. She gave a poor answer in the differential.

Joe is angry when Taub suggests that his son is doing drugs. Kutner administers the nuclear test to Kenny. In order to lose the camera crew, House, Taub and Kutner review the test results in an operating room, dressed in scrubs. There is no scarring on Kenny's heart. Taub insists that Kenny has increased intracranial pressure and would like to do a CT scan. House orders an EP study. Cuddy learns from the film producer that House has been ditching them.

Taub prepares the EP, threading a catheter into Kenny's heart. Taub tries to get Kenny to admit he uses drugs when the patient starts to vomit blood. The camera films House and the Fellows in Cuddy's office. The Fellows have spruced up for the camera. Kutner is wearing a tie and Amber has put on lipstick.

Taub and Cole are assigned to run a scope for stomach cancer although this test may cause Kenny to bleed again. Wilson jokingly tells the camera crew that House is a practicing Wiccan.

House admits to Wilson that perhaps he was blinded by Terzi's beauty and he's not sure if she is up to par with his other Fellows. House gets paged when Kenny starts to bleed from the scope. It could be a mitochondrial disorder, so Taub and Amber are sent to check for signs of retinal degeneration.

The camera crew captures Cameron in the ER with an uncooperative patient. She mixes up her words on camera and ends up saying that she loves Dr. House.

Amber fails to examine Kenny's eye because his deformed head cannot fit into the slit lamp. Taub uses an ophthalmoscope and sees swelling. There is no degeneration. Taub argues with House about the causes. House decides it is Juvenile Rheumatoid Arthritis. Taub goes behind House's back and tells Joe on camera that he will have House tossed off the case.

In Cuddy's office, House and Taub debate. The father refuses putting Kenny on steroids. House fires Taub and wonders why he even took this job. Cuddy intervenes that no one will be fired in the middle of a case. She orders a CT scan to see if there is a midline shift. Foreman and Taub do the test.

House goes to Taub's old practice and pretends to be a patient in for a plastic surgery consult. He is there to glean information about Taub.

Taub waits in House's office with the scans of Kenny's head. House and Taub show Cuddy the films. House says that he talked to Taub's wife. Taub admits that he had an affair with a nurse and when his partners found out, he resigned. Cuddy doesn't see anything on the scan and tells House to start Kenny on steroids for JRA. She also orders Taub to stay away from Joe.

House tries to convince Kenny to start the steroids. Kenny does not like House and only trusts Taub. House thinks the reconstructive surgery will kill Kenny. The father insists that Kenny needs the surgery.

Later that night, House enlists Wilson's help in covertly obtaining the documentary crew's footage to see Terzi up close. Wilson agrees that she made mistakes in the differentials. Cameron wants to fix her comments that she made earlier about House.

Taub shows House the slides again and points out a mass. House concurs with the diagnosis, and they pay a visit to the patient. Kenny is feeling better, but House notices Kenny's pinky finger twitching. Something is off. There needs to be a better diagnosis. Thirteen comes up with Lyme Disease. He displays all the symptoms, except a target-shaped rash associated with the disease. Taub suggests a test to check whether House was right. If Kenny's pacing wire is removed and his heart beats fine, then he can have his operation. If House is correct, then Kenny's heart will stop.

The wires are removed and Kenny's heart is in order. He can have the surgery. As Kenny is prepped in the OR, Thirteen tells the camera crew that if House is right then something bad will happen. She notices on the scans that there is discoloration around Kenny's nose. Thirteen alerts House and stands by her Lyme Disease diagnosis. House dismisses this because there is no sign of the target rash. However, he acknowledges that no one examined him close enough. Chase shaves Kenny's hair and the rash is there.

In the lecture hall, Taub discloses that he withdrew from his practice in order to keep his partners quiet about the affair. House decides to keep Taub and let Terzi go.

House and Cuddy watch a copy of the documentary in which House is edited to look like a hero. House is annoyed and leaves. Yet Cuddy sees the ending as a post-operative Kenny thanks House.