 At the beginning of the episode, Kaylas daughters tell her that  Sally Ayersman has been teasing them, to which Kayla responds, "If  Sallys mean to you again, Im just gonna have to key her daddys  new convertible." Later in the episode, House blackmails a surgeon  into doing Kaylas liver transplant. The surgeon is a Dr. Ayersman,  whose wife, getting an "anonymous" tip about her husbands cheating,  decides to key her husbands new convertible. In Houses words,  "Enough irony for us all."