Directed by: David Straiton
Written by: Peter Blake
Some schoolchildren are singing "Joy to the World" from Handel's Messiah in a school show while their jazz choir classmates wait in the wings. The curtain comes up on the jazz choir, but before they can get too far into the song, Natalie begins vomiting.
House throws a gift in the trash, Taub retrieves it.
Natalie's classmates confess to slipping mushrooms to her. Cuddy sees the patient. The patient thinks Cuddy's pretty. She doesn't think of herself as pretty. She's been the victim of cyber-bullying as well as offline bullying.
Hadley visits Janice (Lori Petty), the patient who dropped out of the test (she identifies herself as "Remy" rather than "Thirteen").
House cruelly mentions to Cuddy the adoption that fell through.
The kid who supplied the mushrooms comes in.
House takes clinic duty even though he's not assigned today. Whitney has a terrible headache, but the patient is actually pregnant. "I'm a virgin, so's my fiancé." "I believe him," House retorts. Later, Whitney brings in her fiancé, who demands a paternity test. House plays along and convinces the gullible man that his fiancée had an immaculate conception due to an extremely rare genetic occurrence that was considered purely theoretical. Cuddy confronts House about the virgin birth lie. That discussion leads Cuddy to realize that Natalie was pregnant. On account of her being overweight, Natalie was able to hide the pregnancy. Cuddy goes to a dilapidated building to find Natalie's baby.
Kutner apologizes to a man he bullied while they were in high school. Foreman puts Janice back on the trial.
This episode contains examples of the following tropes:
- Bittersweet Ending: By the time Natalie is diagnosed, her heart and liver are too far damaged to be saved and she only has a couple of days left to live. However, her infant daughter is found safe and healthy, and ends up being adopted by Cuddy.
- Christmas Episode: It's a Christmas episode.
- Continuity Nod: To "It's a Wonderful Lie", in which Dr. House put his name five times in the Secret Santa.
- "Eureka!" Moment: Cuddy has one when House's virgin birth lie makes her realize the postpartum symptoms in Natalie.
- Happily Adopted: A rare case of the trope being defied. Natalie's baby is put up for adoption because her father and both sets of grandparents decided it would be too painful to raise her. It's then played straight when Cuddy applies to adopt the child instead.
- Improbable Infant Survival: Natalie gives birth to her daughter alone and leaves her in an abandoned building in winter. The baby is found and kept warm by two squatters until Cuddy takes her away for treatment.
- Karma Houdini: Whitney, thanks to Dr. House's lie about a rare virgin birth.
- Mama's Baby, Papa's Maybe: When Dr. House reveals to Whitney that she's pregnant, she vehemently refuses to believe it insisting that she's a virgin and that she's saving herself for her fiancé, with him insisting that they do a paternity test despite Dr. House explaining the risks of doing DNA testing very early in the pregnancy. He eventually has to pull a "virgin birth" diagnoses out of his ass to hide the fact that Whitney really did cheated on her fiancé, all to win a bet against Dr. Willson.
- Meaningful Name: The patient's name, Natalie, figuratively means "Christmas" and literally means "birth". She appears in a Christmas Episode, and her illness is a result of having a baby.
- Teen Pregnancy: The truth behind Natalie's illness; she developed eclampsia a few weeks after giving birth.
