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Dr. Kelso is very proud of the portrait and was perhaps even more proud that it cost a lot of money to have it painted. When the portrait was first hung, Dr. Cox was so upset that he attached a fake engraved plaque on it stating that Kelso had died. The staff had mixed reactions, but Dr. Kelso was upset when he returned and nobody really missed him. ("My Kingdom")
When Janitor begins role-playing as the Chief of Medicine, he places an image of himself over Kelso's face on the portrait. After he is caught, he blames Ted, placing Ted's face on the portrait, although Kelso knew it was Janitor the whole time. ("My Conventional Wisdom")