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House was originally about to reject Valerie's case when Eric Foreman told him that her husband Bill was not only far less attractive than her, but had a modest income. This intrigued House, although he doubted Valerie's motives were pure.
However, Valerie's co-worker shows up and makes drunken threats against Valerie in front of Bill and tries to kiss her, Thirteen gets suspicious about the patient even though Bill doesn't believe anything about what the co-worker said. Thirteen investigates further and realizes Valerie has no emotional response when she does an MRI.
Bill turns out to be non-confrontational and leaves the room just because House tells him to. House confronts Valerie when Bill is out of the room. She admits to being a psychopath, to giving the co-worker drugs to make him throw up, and that her husband has a large trust fund and she plans to get the money from him.
When they suspect Valerie has syphillis, Thirteen makes a comment in front of Bill that indicates she thinks Valerie has been sleeping around. Valerie fakes a cough to get Bill out of the room, then warns Thirteen she will destroy her if she tries something like that again.
However, Thirteen doesn't take the warning. She learns Valerie has been having an affair and covering it up by pretending to take landscaping lessions. When Bill wants to help, he asks him to do an environmental scan of the landscaping class.
Bill learns that the landscaping class was fake and confronts Valerie. She covers herself by claiming she was working late at work and avoiding confrontation over it. Bill believes her. To get back at Thirteen, Valerie files a false harassment complaint.
When Thirteen helps House realize that the psychopathy is a symptom, they hit on Wilson's disease and start treatment. Thirteen tries to tell Bill that Valerie will probably start being manipulative again once she's cured, but Bill says he just wants to go back to being happy with her.
However, the treatment has an unexpected effect - Valerie develops a conscience and when Bill returns she can't help but call him a pathetic loser and tells him she no longer wants to be with him.