Ugly is a fourth season episode of House which first aired on November 13, 2007.
A documentary film crew is following a man with a serious facial disfiguration. Just before they start operating, Chase talks to the documentary crew about the surgery, but all of a sudden the patient's heart rate starts rising and he starts to defibrillate. They have to fit him with a pacemaker wire.
Cuddy talks to House in front of the documentary camera about the case. Chase explains the case, but House reminds him that he knows what Chase is talking about because he's a doctor. The documentary crew starts to follow House, much to his amazement and annoyance. He slams the door in on the camera. Cuddy admonishes him for his actions. She wants the PR. House thinks his objectivity will be compromised. However, Cuddy tells him the documentary crew is paying the patient's medical costs. House reluctantly agrees, then makes fun of Cuddy on camera.
The applicants are talking to Samira. Amber thinks that there will be only one space, with Samira and Foreman getting the other two. House takes the applicants and starts talking about the case. House takes them to the MRI to keep the camera crew out because of the metal in the camera. Amber wants to know why he hired Samira - he tells her that she's got experience in diagnostic medicine. They do a differential. House thinks the patient has been inhaling Freon to get high. He orders a nuclear study to see if there is scarring of the heart. Samira wonders if her job is firm and House confirms she has been hired.
However, House goes to Wilson with a mistake Samira made. He feels he made a mistake hiring her but can't just fire her. Wilson is astounded that he has a conscience about it and figures she must be really good looking.
Taub convinces the patient's father that he might be doing drugs and that's why they do the test. Kutner tells the patient he had trouble in school too, but then feels bad about trying to draw comparisons.
They report the patient's heart is normal. Taub thinks it is intra-cranial pressure. Cuddy is covering with the documentary crew for House trying to avoid the camera, this time in the operating room. House is ordering an EP study when Cuddy comes looking for him.
Taub catheterizes the patient's heart to test it electrically. Taub is also saying how being different is hard before he realizes how stupid he's sounding. He's trying to tell the patient it is okay to admit he's using drugs so they can help him. The patient starts talking about taking drugs, but Taub realizes he's lying. All of a sudden, the patient starts coughing and can't breathe.
The team discusses the patient vomiting blood. House notices his team is now dressed up and/or wearing makeup. House likes only Samira's idea, but Foreman shoots it down. However, Cole comes up with a workable idea, and Taub backs down on intra-cranial pressure before the camera. When he leaves he tells Cole he didn't want to back down - he just didn't want to look bad on camera.
Wilson is goofing around for the camera, telling the crew that House is a Wiccan. House comes in and notes that Samira did something stupid again. Wilson tells him to ask her out. House is paged that the patient is vomiting blood again. It turns out Taub was right about liver failure. House agrees he was wrong, but says Taub is still wrong too. No one comes up with a diagnosis. Samira comes up with another suggestion that Foreman shoots down.
The documentary crew goes to see Cameron to ask her about how House treats his fellows and why she left. She blurts out that she loved House, but then backtracks and says she loved working with him.
Amber is trying to give the patient a scan of his eyes with a machine when Taub steps in with a good old standby of using a scope. He spots swelling, but no degeneration of the retina. Taub still thinks he is right, but House puts the swelling down to the patient's facial deformity. Taub backs down again and agrees to treat the patient for juvenile rheumatoid arthritis. However, when he goes to the father, he says he thinks House is wrong and he can get House thrown off the case.
The father refuses steroids and House realizes it was Taub. House fires him and Cuddy agrees, but tells him not to leave until the case is over. Cuddy tells him to do a CT Scan to confirm arthritis, then he can treat the patient with steroids.
Foreman tells Taub he isn't out if he can redeem himself. He tells Foreman that the reason he's concerned about the patient is that as a plastic surgeon he sees how the patient could be.
Meanwhile, House is talking to Taub's former associate, claiming he needs surgery but really trying to dig out why Taub left a successful practice. The plastic surgeon lets it drop that it was due to personal issues, rather than professional ones. When the surgeon's suspicions are aroused, House admits he was digging and leaves. He then goes back to Taub to argue about the diagnosis and the results of the CT Scan. He embarrasses Taub in front of the camera about buying a diamond for his wife and a fake story that he lost a patient. When they get some privacy, Taub admits he had to quit when his partners found out that he was sleeping around with the nurses. When they come back out, Cuddy tells House he was right and tells Taub to stay away from the family and for House to stay away from Taub's former associates.
House goes to see the patient to tell him he needs steroids. The father wants to see Taub, but House tells them that Taub was only worried about doing the reconstruction surgery, which he doesn't need. The patient still wants the surgery - he can't have relationships the way he looks, even with his father. House reminds him the surgery will only change his face, not who his face made him.
Wilson and House break into the film room to watch Samira make diagnoses. Wilson agrees that Samira doesn't know what she's talking about. Wilson reminds House that he's just a guy. House tells him Cameron was smart, but Wilson starts to doubt that.
Cameron is practicing her lines about how she "loves" House in front of a mirror with Chase watching.
Taub comes to House telling him the patient has a lesion in his head. House agrees, so they can proceed with the surgery. However, House notices the patient's little finger is twitching. House realizes his diagnosis was wrong and the surgery has to be canceled again.
House comes to the team to discuss the twitching finger. Although the patient is improving with steroids, there must be something else wrong with him. Taub accuses House of trying to find something wrong with the patient so they can't do the surgery. Taub suggests removing the pacemaker. House thinks the patient will have a cardiac arrest and brings Kutner along to defibrillate if necessary. The pacemaker is removed without incident.
However, House is not satisfied and stands next to the whiteboard bouncing his ball.
They start planning the surgery again. Remy Hadley is there because she thinks there is still something wrong with the patient, just because House does. All of a sudden, 13 sees something when comparing his appearance with photos shot of his head several weeks prior--a discoloration.
Wilson comes to House to talk to him about how he hires beautiful women because he'e incapable of having a relationship. All of a sudden 13 shows up saying it is Lyme disease, a disease she suggested, but House has already rejected. However, she has found signs of the telltale target-like rash - once the patient's hairline is shaved.
House tells the camera that we like beauty and don't like ugliness. He refuses to answer whether he resents Cuddy interfering with his practice.
House goes to Taub again about why he signed a non-compete agreement so he could no longer practice plastic surgery. He says he did it to shut his partners up so they wouldn't tell his wife. House tells him he isn't fired. He turns to Samira and fires her instead, telling her he prejudged her unfairly, then asks her out. She walks out giving him a major stink-eye.
House sees a first cut of the film, which is edited to make him look like a caring doctor. He's appalled, making a barely audible comment, "The horror..." a nod to Joseph Conrad's Heart of Darkness. Cuddy cries fake tears to make fun of him and asks him if he's off to treat orphans. House says he's going to stop the distribution of the film.
The patient is shown in the film, his facial reconstruction surgery complete, and he thanks House.
- House tells Wilson about hiring Dr. Samira Terzi.
- Terzi begins affecting House's objectiveness and it doesn't take long for him to realise that he's attracted to her.
- House and Wilson discover that House himself acts very strangely when Terzi's around.
- Dr. Terzi is fired.
- House fires Taub but Cuddy lets him stay on until the case is over.
- House begins digging into Taub's past.
- Taub explains to House that he once had an affair with a nurse. When his partners found out what had been going on, he resigned and in order to keep his partners quiet, he signed a non-compete.
- It is shown that Kenny eventually got his surgery.
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