Clark saves Lana from the tornado, leading Lana to be suspicious of Clark. While protecting Clark's secret, Jonathan gets trapped with reporter Roger Nixon in an underground mausoleum. Lex and Clark search for Jonathan.

When Jonathan goes to Smallville Medical Centre for a physical examination, his doctor diagnoses arterial blockage and recommends a triple bypass heart surgery procedure. Meanwhile, Vince Davis, the older brother of Clark Kent's friend Garrett Davis, needs a liver transplant - but does not receive one and he dies. His body is sent to Metropolis to be the next test subject of Lionel's experiment by Dr. Lia Teng, who injects his dead body with experimental blood platelets and revives him. When Vince gets sick again (because he needs the life-sustaining blood injections on a daily basis), the unstable Garrett loses control and becomes a threat to the patients, employees, and visitors of the hospital by showing up at the hospital with a kryptonite-infused bomb strapped to himself, threatening to blow himself up unless his brother receives a new liver transplant. Clark must try to find a way to defuse the situation during Jonathan's heart surgery, while the overzealous Sheriff Adams wants to kill Garrett in any way possible... even at the expense of the hostages. Meanwhile, Chloe does some investigating for Lex of Dr. Teng and learns about the mysterious blood platelet serum she's manufacturing and about the first test subject: Adam.

After an explosion at a LuthorCorp lab, Smallville's citizens "relive" their worst nightmares.

On Christmas Eve, Lex travels to a dangerous neighborhood in Granville, Kansas, dealing dirty means to cut Jonathan Kent of the race to the senate. He is shot twice in cold-blood when a couple of junkies steal his car, and Lex has a near-death vision of having a possible middle class lifestyle with a pregnant Lana as his wife and their son Alexander. In his near death experience, Lex is a simple man beloved by the people of Smallville and best friend of Jonathan and Clark. Meanwhile in the real world, he is submitted to a life-threatening surgery ordered by Lionel to avoid becoming crippled. Also, Chloe asks Clark to deliver many Christmas gifts to poor children, and Clark meets a sad and disappointed Santa Claus contemplating suicide. In the end, Lex concludes that love is cursed, based on the fate of Julian, Lillian and Lana, and power and money are the most important values in his life... which leads to him finally starting down the path of the dark side beginning when he secretly orders the execution of the junkie couple who attempted to kill him.