A construction worker's metal lunch-pail falls from his perch on the building and strikes Dwight Edgar Garrison on the head - resulting in a major family conflict between his current wife and her 2 stepdaughters from his first marriage, on whether he should be buried with his late wife or the widow. Besides having to deal with that, Nate remains unaware that Brenda is still seeing other men but wonders whether she still wants to marry him, or just does out of pity...and whether he should wed at all when Lisa meets him and announces she's pregnant with his child. Claire has doubts about her relationship with Billy, who's also throwing Brenda and her perspective on most of her relationships into confusion. David's relationship with Keith is strong, but Keith's life is troubled when Karla relapses into drugs. Meanwhile, just about everybody finds Nikolai to be a pain while Ruth's working - even Rico loses his sandwich to him. But Ruth is more concerned with the fact that he's in debt to Yuri, a loan shark.

Edith Kirky is the 4th patient of the year to be brought to Fisher and Sons from Bay Breeze Hospital where Vanessa works, so David predicts Rico's usual pride over the fact...but no one predicts him, suspicious about her neck-markings, to discover a whole hot dog wedged down her esophagus. When informing the authorities, Fisher and Sons is forced to allow them to bring Vanessa and her partner to be examined since they failed to find the hot dog themselves. Rabbi Ari encourages Nate and Brenda to be honest with each other, but Brenda reacts badly when Nate informs her he's going to be a father (though fails to mention she's unfaithful to him) and he later talks about it with Rabbi Ari, who introduces him to a Jewish client, Aaron Buchbinder, who needs a pre-meet since he has pancreatic cancer. Brenda's reaction after criticizing Nate is to get high and sleep with a pair. At Brenda's bridal shower, Bernard Chenowith asks Ruth what she's done as far as Claire's depression, but when Ruth visits Gray Deitman to see if she is depressed, the answer comes as a different sort of shock. David encourages Keith to stand up to his father when he and his mother ask that Taylor come to San Diego to live with them, and David himself is forced to find some inner strength of his own to get Catherine Collins, supported by Mitzi Dalton-Huntley, not to sue them for "emotional distress" after Nate's showing her husband's mutilated body at her request. He doesn't have any qualms about becoming angry with Ruth, though, after she pays all of Nikolai's debt to Yuri just before David and Nate have need of the money themselves.