On the island, Jack checks Ben's x-rays and medical file. He tells Ben the tumor in his x-rays, which were taken a week earlier, will be "borderline inoperable" after about a week and says that Ben should have been in surgery yesterday. Ben jumps to conclusions and tells Jack he can have anything he needs and is prepared for the operation right now. Jack walks over to Ben and says:
"No I think you misunderstood me. I never said I was going to do it, I just wanted you to know how you're going to die ... Do you think I trust you people? You think I'll just do the surgery and hope that you let me go?"
Ben says that he is very disappointed with Jack's decision and Jack responds by saying, "Well Ben ... At least you won't have to be disappointed very long."
Locke tells Nikki, Paulo, Sayid and Desmond that Eko was killed by an animal, but Sayid doesn't believe Locke. When they're alone, Sayid asks Locke what really killed Eko. Locke says people call it the monster but he doesn't believe in monsters. Locke believes it may be what brought them there and that Eko died for a reason, he just doesn't know what it is yet.
While Kate and Sawyer are working, a warning sounds; it's a compound breach. Suddenly Alex runs out of the jungle holding a slingshot and firing rocks, demanding to know where her boyfriend is. She's grabbed from behind and taken off. She shouts to Kate that they'll kill her boyfriend just like they killed hers.
Juliet tells Kate that Pickett is going to kill Sawyer, but if Kate can convince Jack to do the operation, she can save Sawyer's life. When Jack and Kate see each other, emotion overcomes them. Kate tells Jack he has to do the operation in order to save Sawyers' life. Jack gets angry that Kate's there asking him to do the operation and refuses.
Kate tells Sawyer about seeing Jack and what they want him to do. Sawyer is glad Jack isn't "dumb enough" to do the surgery. Kate gets angry, climbs out of her cage and breaks open Sawyer's, saying if he doesn't want Jack to save his life then he's going to save his own. Sawyer then tells her that they're on another island; there isn't any place to run. Kate kisses him. Sawyer is surprised, but he kisses her back; they make love. After, Sawyer asks Kate if she really meant it when she said she loved him. She doesn't say anything, but kisses him. He then says "I love you too" and they keep kissing as the scene ends.
Meanwhile, Locke says a few words for Eko and buries him. As he pounds Eko's scripture stick in the ground for the marker, Locke sees a message on it: "Lift up your eyes, and look north, John 3:05".
In the Hydra station, Jack hears static over the intercom in his room. A voice of a woman who sounds very much like Alex tells him to try the door, which he finds is unlocked and unguarded. Jack gets out and finds a weapons cabinet and the surveillance room. Shocked and heart-broken, he sees Kate and Sawyer naked together on one of the monitors. Ben appears behind him and comments that he would have bet on Kate ending up with Jack rather than Sawyer. Jack decides to do the surgery and promises to remove the tumor and keep Ben alive, but wants Ben to keep his promise to let Jack off the island as there is nothing left for him to stay on the island.
Back on the island, Jack starts the surgery. Once Ben is drugged, Pickett goes after Sawyer. As he leaves the operating room, he says that Ben just put his life in the hands of "one of them" and that Shephard (Jack) was never even on Jacob's list. He discovers Sawyer and Kate together and forces Sawyer to his knees with a gun to his head. He's going to kill Sawyer and make Kate watch, when Tom calls over the walkie. Jack sabotaged the operation and says Ben will die in an hour if they don't let Kate go. Jack tells Kate to run. When they're safe, he wants her to radio him and tell him the story he told her on the day of the crash when she stitched him up. Kate doesn't want to go without him, but Jack tells her to run. The episode ends.
In the first flashback, Kate checks into a hotel room and looks at her wedding veil. A policeman, Kevin, knocks on the door and demands to be let in. When Kate opens the door, she jumps into his arms, we learn that they're a couple and are to be married in 12 hours. Kate, or Monica, as she is known as to her soon-to-be husband, has a moment of doubt, but Kevin assures her it's right and real because he loves her. Before her wedding, a woman called Suzanne, gives Kate a gold locket her mom had given her. Kate tells her mothers-in-law aren't supposed to be so nice. During the ceremony, the Minister talks about Kate's honesty and faithfulness, and how what you see is what you get. A while after the ceremony, Kate calls U.S. Marshal Mars. She doesn't want to run any more, and pleads for him to stop chasing her. He guesses it's about a guy. She tells him she loves the guy and the Marshal agrees that if Kate can really stay put, really settle down, he'll stop chasing her, although, it's unlikely that Kate ever will stop running. Later, we see Kate with pregnancy test results: she's not pregnant. She shows a sign of relief. She finally tells Kevin she's a fugitive on the run for killing her father. She drugs Kevin and leaves.