The city's nurses are on strike and one of them, Deb, is on the picket line with her husband Jeff. A deliveryman tries to get past the line but they hold him up for the allowed 15 seconds. When he tries to shove by anyway, Jeff genially tries to talk him out of it and ends up giving him a hug. After the 15 seconds are up, Jeff lets him pass.. then has a convulsion and collapses.
House is hiding from Cuddy in the ER when he spots a cheery Jeff just sitting there, waiting and smiling. Curious, House goes over and finds out that Jeff is completely and entirely happy, despite the lack of service. Even stomping on his foot doesn't break his mood. House suspects something is up and orders a differential for Jeff. The team doesn't believe anything wrong and figure that House is just trying to prove that no one is that happy without a medical reason. House ignores them and tells Foreman and Kutner to check out Jeff's house.
House invites Chase to go bowling because it's one of only two things men shouldn't do alone. Wilson is busy dating Amber, which means he doesn't have time for House. House discusses the situation with Chase, who mentions that Cameron has an insufferable friend and they made up a schedule of when she got to see her friend. House runs with the idea and goes to Wilson and Amber, and suggests he share joint custody of Wilson with Amber. She's not too thrilled with the idea, but Wilson notes this is actually an example of House being reasonable. However, they can't agree on a schedule and Wilson refuses to get caught in the middle.
At Jeff's house, Kutner and Foreman discuss the fact that Jeff is so happy, and Foreman notices chemicals that might account for neural disorders. Meanwhile, House and Amber meet with Cuddy and demand she resolves their scheduling issues. Cuddy refuses until House does his performance reviews. House would rather not but finally signs off on her evaluation of him… and Cuddy rules against him.
Kutner informs House that the tests have come back negative but notes there is a low calcium level. House concludes from the calcium levels that Jeff has Williams Syndrome, but Thirteen and Taub note that Jeff doesn't have any of the other genetic markers. House sticks by his theory, and then Jeff has a stroke.
It's back into differential and House now believes Jeff has syphilis. While discussing his theory, he also gives very brief performance reviews of the team. Foreman objects to the whole thing and eventually ends up volunteering to do them himself since House hates the paperwork. Kutner goes over Jeff's sexual history and determines that he tested negative for STDs ten years ago when he joined the Peace Corps, and hasn't been with anyone but his wife since.
House is waiting at his apartment when Amber drops off Wilson… 16 minutes late. House is angry, even though there's no tee-off time for the miniature golf game he has planned with his friend.
Thirteen suggests some heart tests to Foreman but he's more interested in doing her performance review. She doesn't take him seriously and leaves. Kutner confirms that Jeff has syphilis, even though the patient insist that he must have got it himself rather than blame his wife. Deb says she never had an affair and says she loves her husband because his niceness inspires her to be a better person. The team prescribes penicillin to test the syphilis, but Kutner warns Deb that it could change Jeff's "perfect" attitude.
Foreman tries to complete the performance reviews, but Taub point out that he doesn't have any authority or is superior to them: House is just pretending to give Foreman the authority to humiliate him. Kutner wonders if there's something wrong with House. Meanwhile, House and Wilson are at a bar and House is getting his friend drunk to mess up his relationship with Amber. They're interrupted when the team calls House to reveal that Jeff is vomiting blood and probably has hepatitis. House tells them to run more tests and then admits to Wilson he's trying to break up his relationship with Amber. Wilson staggers off, mildly angry.
As the team runs tests, Kutner tests an old blood sample of House's and discovers that he has syphilis. They go to see House and give him the news, and give him penicillin. House is seemingly upset that they know about it. The team then give the news to Chase and Cameron, and wonder if curing House's syphilis could change is attitude and make him a poorer doctor. Chase wants to know if Cameron ever slept with House, but she tells him it's none of his business... so he figures she did.
House goes to see Wilson with the news about his syphilis, but Amber confronts him and says she isn't going to stand for his efforts against their relationship, and figures he isn't going to stop. She amends their agreement, saying now she wants to attach penalty clauses. House agrees, and refuses to tell Wilson about the syphilis figuring he'll tell Amber.
Foreman confronts House and asks him to formally put him in charge of the team as second-in-command under House. House refuses, claiming he wants the team to question Foreman so they'll be better at their jobs. Foreman doesn't believe it for a minute.
Deb visits Jeff as he goes on the new medication, and it's clear his attitude has changed and he's furious. He goes into cardiac arrest and she saves his life due to the shortage of nurses. In differential, House seems curiously subdued, mocking himself and letting everyone vote. He even gives up his marker and lets Foreman make the call. The team continues to worry that House's "cure" may be changing him into a different person… and a lousy doctor.
However, House can't resist and goes to tell Wilson what's really happening: he planted the phony blood sample and is toying with the team, making them think he's nicer. The two of them end up going bowling during work hours, voiding House's part of the agreement.
The team continue to test Jeff while wondering if they should cut back on House's penicillin treatments. Amber comes in and ruins House's plans by telling them about his fake syphilis: Wilson told her. Kutner goes to House and tells him that they know: House isn't thrilled. However, since House used a false test, Kutner wonders if something else might be testing falsely for Jeff's syphilis. He concludes that Jeff might have Chagas Disease, which is similar to syphilis and can be found in countries like Costa Rica where Jeff served in the Peace Corps. He confirms his diagnosis with a new MRI, noting the penicillin treatment set off the heart attack. They give Jeff and Deb the good news: Jeff caught Chagas ten years' ago and it altered his personality ever since, but it's easy to treat.
House gives his performance reviews to Cuddy, but she quickly realizes he just copied the same basic stuff over and over. Still, she got more then she figured. House then gives her a performance review of her love life, which isn't too constructive. Cuddy counters by noting that Amber has claimed House violated their agreement by going bowling with Wilson. House counters by noting Amber breached confidentiality with the fake syphilis news, so Cuddy decides to penalize them both.
Jeff and Deb share a meal and he reveals he no longer likes ketchup. She wonders what else he might start disliking. And House and Amber end up changing bedpans, while Wilson watches them and smiles, since he's come out head on the whole deal.
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