"Rebellious" fully participated in the differential diagnosis in all three cases, but did not impress House with his diagnostic skills. The matter came to a head when House discussed the case of a man in his mid-thirties who presented with pain in his right leg, tea-colored urine and elevated creatine kinase levels. The rebellious student was sure that the elevated CK levels pointed out the pain and waste in the urine were the result of trauma to the muscle and not an infection, most likely due to the patient's intravenous drug abuse. All the patient needed was bed rest. House called him "useless and oblivious".
In fact, "Mid 30s man" was House discussing the incident that led to his disability. The symptoms were due to a rare condition, muscle death, which required an immediate MRI and emergency surgery. The pain was due to an infarction from a clot in House's leg that caused hypoxia in the thigh muscle. The dying muscle released myoglobin which tinged the urine brown, and also released the creatine kinase. Rest only made the condition worse as the muscle continued to die.