The episode begins, and as it turns out Sophia is still missing. Carl meanwhile is still ailing, and his condition is getting worse, from the looks of it. Meanwhile, Shane and Otis are running through the hallways of a school overrun by walkers, doing their best to stay alive, and return with the medical supplies to Hershel. Rick, meanwhile, assures Lori that Shane will return with what Hershel needs to operate on Carl. Lori though doesn't appear completely convinced, and is visibly worried about her son’s fate. Daryl meanwhile is camped out with Andrea and a weeping Carol. Then feeling sympathetic, Daryl offers to take a walk in the middle of the night to search for Sophia.
Andrea volunteers to come along. "Are you sure this is the best idea?" asks Dale. The two though ignore the voice of reason, and decide to go despite the warning. Back at the school, Otis and Shane are meanwhile trapped at the top of the gymnasium bleachers. Otis then makes a run for it in one direction while Shane runs toward a window in the opposite direction. He then shoots a zombie in the face at point blank range before falling multiple stories to the ground. He in the end limps away, and doesn’t seem to be seriously hurt. Meanwhile, T-Dog and Glenn show up at the Hershel farm house and meet Maggie on the front porch. Glenn appears love struck from the looks of it.
Daryl meanwhile explains to Andrea how he had once disappeared into the woods for nine days, as a child. He from the looks of it is basically trying to convince Sophia that, things might just be ok, in the end. Andrea though isn't convinced. Back at the farm, Hershel announces that they might have to operate on Carl without the respirator as the boy is fading fast, and hence there isn’t any other option. "Maybe this is how it's supposed to be," Lori tells her husband, who refuses to believe that Carl is better off dead, regardless of the current world order. Lori meanwhile brings up Jackie, who chose death. "I don't accept that," Rick says, not convinced by Lori’s argument. "I can't accept that" he reiterates.
Rick in the end is unable to explain himself, when pressed to explain why Carl would be better off living in a world overrun with such a horrible plague. Shane, in the meanwhile, is about to be overcome by walkers when suddenly a shot rings out, exploding some zombie heads. Turns out, it's Otis and he from the looks of it, has managed to save Shane’s life at least for the time being. Back at the farmhouse, Carl wakes up and is suddenly lucid, much to everyone’s surprise. "Where are we?" Carl asks. "It hurts", he then exclaims. Lori meanwhile, strokes her boy's head as he talks about the pretty deer and then suddenly he goes completely still.
Lori gasps fearing the worst, and then the boy undergoes a violent seizure. "His brain isn't getting enough blood," Hershel explains. Rick then offers his arm for the umpteenth time. Meanwhile, Daryl and Andrea sneak through the dark woods and come upon a campsite. They find a walker hanging by his neck from a tree. Turns out, the guy tried to commit suicide before turning, but forgot to shoot himself, in the head. Animals have munched on the swinging zombie's legs. "He made his choice," Daryl says. “Let him hang" he then says. Andrea meanwhile confesses that she doesn't know if she wants to live or if it's just a habit. Daryl then honors her request to show mercy and shoots the walker in the head with an arrow, putting it out of its misery.
Back at the farm house, T-Dog gets stitched up by Patricia while Maggie catches Glenn praying. "This is my first try," says Glenn with a dispirited laugh. Maggie notes that quite a few prayers have gone unanswered as of late. Dale, meanwhile, has decided to ignore his own advice and go searching for Andrea and Daryl by himself, as he is apparently worried about their safety. He later approaches the edge of the highway and then stops, uncertain of how to proceed. Rick meanwhile earnestly tells his wife that Carl's moment of lucidness is a message. "He talked about the deer, Lori" Rick says, visibly excited. In other words, he focused on life rather than death. Otis and Shane, in the meanwhile, continue to fight for their lives outside the school, trying their level best to escape from the scene.
Hershel meanwhile, demands that Lori and Rick make a choice. The choice is between, operating Carl, or letting Carl slip away. "We do it," she says through tears. Carl is then put on a table and the doctor picks up his scalpel. Then right before he is about to make the first incision, Shane roars up to the front door in the pickup truck. Rick is visibly relieved at his arrival and hugs his friend, who is clearly very, very shaken. He admits to having left the slower Otis behind in order to return as quickly as he did. Meanwhile back at the road, Dale it turns out doesn't have to go out into the woods, after all, as Andrea and Daryl return, but without Sophia. "The choices I made for you were not mine to make," says Dale, handing over Andrea's gun to her. "Please, don't make me regret this" he further tells her.
Sophia meanwhile is trying her best to forgive Dale. Back at the farm house, Maggie weeps over the apparent loss of Otis and the loss of all her family and friends. Glenn meanwhile, does his best to comfort her. Later, Hershel emerges onto the front porch and tells Lori and Rick that Carl has undergone surgery and appears to have stabilized. Lori and Rick weep, apparently relived at receiving the news. Hershel informs them that, Carl as it turns out might just recover. Hershel now must turn his attention to breaking the bad news to Patricia, who nearly falls over when told that Otis did not make it back.
Shane meanwhile, can barely watch the scene. He then walks into Carl's recovery room to find Lori crying over her boy. The two former lovers look at each other. "Stay," Lori then pleads him. Shane says nothing. He then walks slowly to the shower and examines his wounds. A tuft of hair has apparently been pulled out of this head. The scene then flashes back to Shane and Otis limping away from a wild pack of zombies. Suddenly, Shane uses his last bullet to shoot Otis in the leg. Screaming in panic, Otis latches onto Shane and pulls out a chunk of his hair. After a furious struggle, Shane somehow manages escapes, leaving Otis behind as a distraction to the walkers, who envelop him and tear him to shreds.
This enables Shane to get away and consequently save Carl. Back in the present, Shane looks extremely disturbed while recollecting all that has just transpired. Later Shane is shown staring into a fogged over mirror, having just shaved his head to hide the last evidence of his struggle with Otis. The episode ends at this point.