The episode begins with Daniel Pierce asking his neuroscience class: What is reality? Well, he does not get the answers he is looking for. So, he tells the class that reality is a figment of our imagination. He then tells about dreams and nightmares; and says that if what we perceive is often wrong, then how do we know what is real and what isn’t! Next, we see Lewicki following Pierce and telling him to eat; well he is the guy who takes care of Pierce’s schedules, Food and puzzles. Just then a student approaches him and asks him if she could buy him a latte; she wants to discuss her term paper. But he tells Karen that discussing her term paper is a code for sex and so he declines it.
Later, Pierce is listening to music and solving crossword. Just then Kate Moretti approaches him; she is a Federal Agent and his former student. She has brought a case for him to solve; the death of a pharmaceutical lawyer guy named Clark. His wife has confessed that she is the one who murdered the Clark. But Kate thinks that Pamela is too thin and no way could she have bashed her husband’s skull in. So, the confession seems coerced. The pharmaceutical company’s top executives received death threats telling them that they were poisoning people. Next, Pierce interrogates Pamela. He asks her as to why she killed her husband. Pamela says that she doesn’t know. But it appears that she told the police that she wants the insurance money.
Apparently, Pamela agrees to whatever Pierce tells her; even taking home a stray kitten. Pierce comes out and tells the Detective that Kate was right; Pamela is innocent and she has Korsakoff’s syndrome. It is a neurological syndrome, where she remembers something when she is told something; irrespective whether it is the truth or a lie. So when she was told that she murdered her husband, she thinks that is the fact and she says that she did. Whatever the case may be, she doesn’t belong to jail and needs a hospital. Detective Hammond is clearly unhappy. Daniel is waiting for Kate while Kate tells Hammond to transfer Pamela to a psychiatric ward. Everything in the office starts getting to him; it is driving him crazy. Hammond calls him a “nut job” and Kate defends Pierce.
But just then they see that Pierce is standing on a table, conducting the music from his headphones. Well, he might appear crazy; but actually he is schizophrenic. Next, Kate talks to the executives of the pharmaceutical company, Tech San. She wants access to all litigation files against the company. Kate then shows Pierce the anonymous emails that were sent to Clark. He goes through the emails and figures out that there is an anagram: scum needs a hearty reminder. Kate is surprised. It actually means: Tech San murdered Irene May. Kate runs a search on Irene May. It appears that Irene’s son, Timothy filed on her behalf. Agent Robert appears to be shocked. They then go to Timothy’s apartment.
They break open the door. Timothy tries to escape through the window. Kate announces herself and follows him. She then jumps on him from the fire escape and Pierce thinks that it was crazy. Next, Kate and Pierce interrogate Timothy. He tells them that he did not kill anyone; but he also doesn’t want to co-operate with the government. Pierce sends Kate out on the pretense to get him some tea. Pierce manages to get through to Timothy by expressing his dislike for processed sugar and diabetes. He also tells him that he is not a Fed but a college professor. Timothy relaxes a bit and starts opening up. He tells Pierce that his mother had diabetes and a drug that was given to her by Tech San gave her a heart attack. He is angry at them as they did not even pay for the funeral.
But he still maintains that he is not a murderer. Kate tells Pierce that they have the man who was making threats in their custody and the murder is a police matter. Kate tells Pierce that she was demoted as she had a tendency to go beyond the scope of her investigation. And both of them know that they cannot let this case go away. Next, at Tech San, Kate talks to Dr. Bryan. Pierce questions Bryan about the effects of a drug called ‘insuprin’ and tells them about Irene’s case. Allan, an executive of the company, tells them that the case was dismissed in summary judgment. Bryan’s expression changes and on being asked, he tells Pierce that Irene was in the placebo group and she wasn’t even taking the drug. Just then, Pierce notices a man working in the lab. As Pierce approaches that man, Hammond walks in, searching for Valerie Nelson. He says that Pamela had another motive to kill her husband.
He was having an affair with Valerie and was supposed to leave Pamela the night he was killed. Kate feels that Pamela just did not remember why she killed her husband; but Pierce thinks that she is wrong. He feels that Pamela is a victim. Kate offers food but Pierce turns it down saying that he has an appointment. He then meets Natalie. Natalie tells him that he should have said a yes. She also knows that consulting disrupts his routine. But he tells her that Lewicki keeps him organized and he is confident that Lewicki wouldn’t graduate soon as he keeps changing his majors. Natalie then leaves. After sometime, the door bell rings. It is the man he saw at the lab. The man says that he is Gerard Permut and that he has information on Clark’s murder. He tells Pierce that he did what the voices in his head told him to do.
He says that he was in love with Valerie and that she said that they could have a life together. But then she was sleeping with Clark and when he found out about the affair, he killed Clark. Pierce calls out to Lewicki. When Lewicki comes down, Pierce tells him that there is a situation; but by gauging Lewicki’s expressions, he realizes that there is no one there. Gerard was a hallucination. The next morning, Pierce is still seeing Gerard. Lewicki tells Pierce that maybe Gerard is not only some hallucination; maybe there could be some love triangle going on. Just then there is a call and Dean Haley wants to see Pierce; it is about Karen. He wants him to apologize to her and her friend, who filed the complaint. Natalie tells Pierce that he turns downs any such offers as he is petrified about an intimate connection with any human beings.
He tells her about his hallucinations and tells her that he is incapable of any intimate connections. She knows about the incident that happened with him. But he seems more worried than usual. It is because he does want it to happen in front of Kate. Natalie suggests going back on medications; but he denies. Natalie says that the hallucinations at times tell him that his mind cannot see. He tells her about the incident. And Gerard also called Valerie Nelson a liar. Pierce takes Kate to visit Jimmy; he is an aphasic who is unable to comprehend regular speech. However his condition makes him pick up some deflections in the speech of a person who is lying and they find it funny. So, when Jimmy is shown Valerie’s interrogation tape, he laughs. They confirm Valerie is lying.
Pierce and Kate go to Valerie’s apartment; but they find her lying in a pool of her own blood. Somebody attacked her. Robert wonders as to why Kate is still solving this case. Kate then talks to the executives and finds out that Valerie had some information that could be dangerous to the company. Robert and Pierce are watching the interrogation, when Gerard appears again. Pierce manages to get Robert to leave the room. Gerard tells Pierce that the murder weapon is poison. He also points out to his own name and reminds Pierce as to how much he likes puzzles. Gerard Permut is an anagram for “drug tamperer”. This means that someone tampered with the study results; and they infer that it could be Dr. Bryan. Kate approaches Bryan and tells him that he tried to kill Valerie as she found out that he was falsifying the reports. He smirks.
But then she says the name to the shoes he is wearing and tells him that he left a bloody footprint at Valerie’s house when he had gone there and attacked her. Bryan confesses that he attacked Valerie. But he also tells them that he found out the reason why the drug was causing heart attacks and he was working on it. But Valerie was collecting evidence against him. But then he saw her stealing pills and so he followed her. He saw her giving them to Clark. He tries convincing Clark; but when Clark threatened to call the police, Bryan picked up a trophy that was kept nearby and smashed Clark’s skull. Later Kate tells Pierce that the footprint story was a lie.
Just then Pierce sees Gerard again. The case isn’t over yet. Pierce rushes to Bryan and asks him the reason why the drug was causing heart attacks. It was because the drug depletes the thiamine levels in the body. And decrease in thiamine causes Korsakoff’s syndrome; the one Pamela was suffering. They visit Valerie. Pierce tells her that Bryan was too paranoid and he thought that Valerie was supplying Clark the pills as evidence. But in fact Clark and Valerie were feeding the pills to Pamela to give her a heart attack. And she had informed the CEO of the company as she needed a cover story. Valerie lawyers up.
Gerard disappears. Next, Pierce calls for Karen and he apologizes to her. but she takes her shirt off and tells him that he was right about the coffee offer. Pierce calls Lewicki and asks him to check whether this one is real; and yes it is! Next, Pierce is sitting and talking with Natalie. Lewicki arrives. There is no one sitting next to Pierce; Natalie is one of his hallucinations! He gives Pierce his music and leaves. The episode ends.