Lex is committed to the Belle Reve Sanitarium for the criminally insane by Lionel who forces the shrink, Dr. Claire Foster, to submit Lex to an experimental electroshock therapy technique to erase his memory and forget his past events. Clark visits Lex and after finding out, decides to try to save his friend, despite protests from Jonathan and Martha that Clark's secret is known by Lex. But three of Clark's adversaries reside in Belle Reve. They are the arrogant, power-stealing Eric Summers (from episode "Leech"), the angry, meteor-rock mutant racist Van McNulty (from episode "Extinction") and the double-clone Ian Randall (from episode "Dichotic") who join forces to attack him so Eric can steal Clark's powers again and and escape from the asylum. Meanwhile, Lana begins to distance herself from Clark while she's attending physical therapy to recover from her broken leg with the support of a charming patient named Adam Knight (Ian Somerhalder).

After leaving an article full of denunciations about the "Summerholt Neurological Institute" with her former colleague of the Daily Planet, Max Taylor, Chloe is chased by Clark Kent who tries to run her down with his truck. He claims that he had received an e-mail just before his action. Later, Lana also receives an e-mail from the same address and tries to kill Chloe on the steps of Smallville High, who is saved by Adam Knight. Clark and Chloe, with a little help from Lex, investigate the mysterious e-mail origin, and they discover that Molly Griggs, a former patient of the unethical Dr. Garner, is using her meteor-rock abilities to force people to kill through a hypnotic suggestion in her e-mails. Meanwhile, Adam moves to Smallville to be close to Lana despite that nobody knows anything about him. Also, Lex makes contact with Dr. Garner and threatens to expose his unethical practices unless he helps him regain his memory of the last seven weeks.

Jordan Cross is a new transfer student to Smallville High School who has a frightening ability: when he is touched by another person, he immediately sees how he or she will die. When Clark saves the suicidal Coach Altman from death, the future of other people changes, including Lana's. Jordan also learns Clark's secret after he physically bumps into him. Meanwhile, Chloe finds that Adam is injecting himself with some kind of experimental medication, while his increasingly erratic behavior troubles Lana. When Jordan touches Adam, he tells Lana that Adam had already died. Also, Lex continues to investigate his past to regain his memory.

While returning home after leaving Jonathan Kent in the hospital recovering from a heart attack, the truck of Martha and Clark is almost hit by two cars racing in the road. For the greatest surprise and deception of Clark, one of the drivers is Pete Ross, who has become the friend of the bad element Jason Dante whom is using meteor-rock synthetic fuel to win at drag races. Pete does not accept Clark's advice and gets into serious trouble when Dante wants $20,000 of losses after thinking Pete betrayed him to the police. Meanwhile, Lex investigates the prominent Dr. Lia Teng about her research of blood platelet with Adam Knight, and Lana feels threatened by the mysterious dark secret of Adam after finding out that he "died" of a rare liver disease and learns about the mysterious blood platelet drug he is taking to keep himself alive.

While in an elevator at Luthor Corp with another girl during a class field trip, Clark is forced to use a few of his abilities when the cable of the elevator accidentally breaks and in the process, the student, Alicia Baker, witnesses Clark's ability of heat vision and punching through steel and in return, Alicia 'teleports' herself and Clark out of the elevator. Clark confides his secret to Alicia who confides her secret of being a meteor-rock mutant with the ability of teleportation. Soon, Clark and Alicia start to get closer and he starts to really think that Alicia could be the one for him. But Alicia on the other hand, turns out to be an obsessed sociopath who wants Clark... NO MATTER WHAT! When Clark starts to realize Alicia's obsession with him, he decides to put an end to their brief relationship. But Alicia won't settle for second and sets off to kill Clark's true love Lana. Elsewhere, Lana finds a journal that Adam has and finds out that he has been spying on her and Clark... under orders from Lionel. So, Lana turns to Lex for help with this situation.

While working as a volunteer with Pete at Smallville Youth Center, Clark receives a distress phone call from Lana, who is shot by Adam. His further investigation shows that the call was made from the future because of a time/space porthole created by a massive electrical surge from a downed power line fitted with meteor rocks, during a coming thunderstorm. Clark must try to save Lana and change the future. Meanwhile, Lionel Luthor shuts down the obscure Merton Laboratory and the research that Dr. Lia Teng is developing with blood platelet, which were finally revealed to have been developed from the vial of Clark Kent's blood. Adam becomes aware that he has less than 12 hours to be injected with the serum, otherwise he will die. He escapes, kills Dr. Teng and her whole team, and Lex is framed as responsible for the mass murder. Adam then sets out to find Lana to know if she still has an extra vial of serum for him. Lex later meets with an FBI agent, named Frank Loder, who enlists his help to bring down Lionel Luther, who also confides in an associate of his about his research and reveals the reason for it: Lionel himself is dying from a rare liver disease.