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Kayla McGinley needed a liver transplant, but no transplant surgeon would give it to her until the donor, who was her brother Sam, had time to weigh the decision. House goes to Dr. Ayersman and bribes him with twenty-thousand dollars, but Ayersman makes six-hundred thousand dollars a year so he doesn't really need it. House tells Ayersman that he knows that he is cheating on his wife and sleeping with series of nurses, most recently Nurse Cutler. Dr. Ayersman agrees to do the transplant. House tells him that he is the worst transplant surgeon in the hospital, but he is the only one who is currently cheating on his wife. House leaves, and Dr. Ayersman successfully completes the live donor surgery. House tells Mrs. Ayersman about the affair anyway.