Adam is seen jogging with Ed at the beginning of the episode. Adam jokes that Ed probably can't keep up because he had just had sex with his wife Elise.
Elise, however, has been suffering from hypersomnia. Her symptoms are eventually traced to African trypanosomiasis, and Gregory House realizes she could only have contracted it by having someone with the disease. Ed had believed that Elise had been faithful to him, but when he realizes she must have cheated on him, he leaves the hospital just as she recovers. Elise finally admits that she had an affair with Adam, and Allison Cameron goes to see him to advise him he needs treatment.