Cullen wakes up in a field, surrounded by furniture. He asks a boy for water but the child threatens him with a knife and then runs away. Cullen tries to follow but falls to the ground in pain.
Back at Hell on Wheels, Ruth hands Cullen a sick list. People are sick and end up dying after they drink water. Cullen finds dead rats in the water and thinks this has caused people to get cholera. A man asks what the cure is and Cullen says they need to find clean water. He orders the men to either go to the infirmary or continue working. One man isn't too happy about this and threatens Cullen. Elam knocks the man out before he does anything though.
Durant plans for Cheyenne to become a hub for rail travel but Senator Metcalfe says he needs money because he is being audited. He wants Durant's stake in Credit Mobilia to pay off his debts. While they threaten each other and struggle for the stock papers, Durant shoots Metcalfe in the heart. As Metcalfe dies, Sean comes looking for Durant. He hands the gun to Sean and passes the blame onto him.
Cullen visits the hotel to talk to Durant about business. He wants to buy as much water as he can from Durant. Durant refuses and says that if Cullen tries to take the water by force, he will empty the tanks into the street.
Sean visits Mickey at the brothel and Mickey knows right away Sean is in deep trouble. The two leave together.
As Eva walks with her baby near the church, Ruth warns her to stay as far away as she can. Eva visits Mr. Toole at his home. He complains that the town is beating him down and he is thinking of taking a train home. Eva tells him that she wants to go to New York with him and he thinks it is the right decision. She wants to leave to ensure her baby's safety.
Cullen confronts a group of men who want to leave because of the lack of water. He tells the men to stay or walk, but they can't take the railroad's horses. Cullen shows Elam a map of the location of a small spring of water that's about 20 miles away. Elam asks Cullen if he drank the tainted water and if he's all right to ride out to the spring. If Cullen doesn't find fresh water he will likely die from cholera.
On his way to the spring, Cullen stops to give his horse some water. He notices that his hands are yellow from the cholera. The horse runs off to a nearby pond to get a drink. Cullen is about to drink when he notices a sign marked with a skull and crossbones in the water. There are also dead animals in and around the pond.
Psalms tells Elam that he hasn't felt heat like this in three years. He also talks about all of the types of heat he has encountered. Psalms tells Elam that after he marries Eva and gives the baby a name everything will be aright at home. Elam wants to name the baby Rose and Psalms agrees that it's a good name.
Elam visits Eva to tell her about the windmill, that he built with Psalms which will hopefully bring them water. Eva asks if Elam will love her no matter what and he promises he will.
Sean brings Mickey to the body of Senator Metcalfe to help him dispose of it. Mickey tells Sean that Durant just wants to pin the murder on him. Mickey says that he is done helping Sean clean up after his messes but Sean really needs the help. Downstairs in the hotel, Mickey tells Durant that he will help him clean up the mess if he does exactly what he says to. Durant laughs at the thought of listening to a saloon keeper but Mickey promises he will help him this time.
Out in the wilderness, Cullen is sick from the cholera. He digs around in the ground but only finds dirt. He wanders over to a bunch of furniture sitting around and falls asleep. He is woken up by a boy who gives him some water. The boy is Ezra Dutson, and he holds a knife. Cullen hands him a piece of jerky and asks Ezra where he got the water from.
Back at Hell on Wheels, bodies are thrown together for a funeral pyre. Sean and Mickey say that they have one more body to add to the pile before they burn them. They roll Senator Metcalfe's body onto the pile before the pyre is lit on fire. Sean thanks his brother but Mickey says he never wants to see Sean in his life again.
In her house, Eva grabs a knife, cuts her finger, and puts markings on her baby's face similar to the tattoos that she has. She sings a song to the baby.
With the help of Ezra, Cullen digs a hole in the ground and finally finds fresh water.
The Swede shakes the hand of a man and says he is Bishop Dutson. The man says they expected him weeks ago and they were sent to look for him. The Swede says, in an American accent, that heathens attacked his family and took his wife and killed his boy. The man says they should get him back to camp.
Elam finds Cullen and Ezra. They erect the windmill and start pumping fresh water. Cullen lies in wait on the back of a wagon. Elam and the men wait for the water to come and when it does it is very dirty to begin with. They erupt into cheers when the water comes out fresh. Psalms delivers Cullen fresh water. After drinking as much as he can, Cullen yells for them to fill the tanks.
Back at Hell on Wheels, Cullen recovers in the church. Ezra lies next to him and panics when he sees him. Cullen offers to play some cards with Ezra. As the two play War, Ruth watches and smiles.
Eva boards the train with her baby and Mr. Toole. He says she will love the city but Eva isn't going. She is only sending her baby to New York. Mr. Toole is shocked and says he doesn't even know her name. Eva says her name is Rose and leaves the train.