Taub is the one doctor who steps up to the differential. As the only plastic surgeon on the team, Taub has seen cases like Kenny’s before. Taub thinks Kenny’s heart problems are a result of increased intracranial pressure. However, he won’t argue his case in front of the camera, because he’s afraid that he will lose the argument and end up looking like an incompetent doctor for all future employers. It is not until House orders a steroid treatment for Kenny for juvenile rheumatoid arthritis, that Taub finds the courage to admit to Kenny’s dad and the camera crew that he thinks House is wrong and tries to have House thrown off the case.
House uses this betrayal as an excuse to visit Taub’s former employers to dig up a little background information. He learns that Taub had signed a non-compete agreement with the plastic surgery practice that he worked for and that he had told his wife that he quit because he lost a patient. Taub confesses the truth to House. He had an affair with a nurse that became a big deal. He agreed to quit the practice and leave his chosen field in order to keep the information from his wife. Instead of admitting his infidelity, Taub wants his wife to believe that he is a noble, loving husband.
Thirteen is the most reluctant person on the team to speak in the presence of the camera. Instead of offering her brilliant diagnoses, she clams up. Her one suggestion that Kenny’s symptoms indicate Lyme disease was dismissed by House because Kenny did not have the bullet rash. When Kenny’s operation takes place, despite House’s objections, Thirteen is there to observe. She tells the camera crew that if House believes something will go wrong during the operation because Kenny hasn’t been cured, then she wants to be there. Her loyalty to House’s brilliance reminds me of Cameron.
It turns out that both House and Thirteen were right. Thirteen notices some discoloration around Kenny’s hairline. When she pulls back the hair, the bullet rash is there. Kenny does have Lyme disease. House witnesses the discovery with Wilson. In a back-handed compliment to Thirteen, House says she’s getting uglier all the time.
Article comments
1 - anon
Nice analysis of this episode.
Just one correction: it's "bull's eye" rash, not "bullet" rash.
The medical facts on Lyme were a bit off in this episode. The bull's eye rash is a sign of recent tick bite, it is not a symptom that remains in later stages of the disease. Even if someone goes untreated and develops full-blown Lyme, the rash still disappears on its own.
Cardiac symptoms can present earlier, but generally they are a later-stage symptom, meaning months to years after infection. If the bull's eye rash were still present, the boy's cardiac symptoms would be very, very unlikely to be caused by Lyme in the real world. If the boy had undiagnosed Lyme long enough to have such serious cardiac involvement, there is almost no chance he would still have the rash.
2 - cindyc
Thanks for the correction. Lyme disease is a concern where I live and I've known people who have had it in various stages. It is more than an inconvenience. Some people don't take it seriously enough.
CindyC