MacGyver travels to Russia to meet with Pete Thornton, after he discovers that Pete took off on his own after obtaining a Soviet ID. Pete explains that a Nobel Peace Prize nominee, Alexander Karsoff, died three days ago while undergoing interrogation. The authorities suspected that Karsoff was working with an American agent. Pete admits he was the agent, but he was only helping Karsoff get letters from political prisoners to their families. Pete has traveled to Russia to save Karsoff's daughter, Maria, who is scheduled for imprisonment. MacGyver insists on helping and Pete agrees, but asks him to wait while he contacts Maria at her father's nearby cabin. MacGyver agrees… and then follows Pete.
Pete goes to the cabin and meets with Maria. He explains that the secret police are coming for her, but they arrive before they can get out. Pete has Maria answer the door, and then shoves it open knocking them off the porch into the lake below. As they run for it, MacGyver jams a potato in the exhaust pipe of the pursuit car. They get to the lake and escape in a motorboat, but the secret police take a jet boat and follow. MacGyver makes a mess of ropes, empty fuel cans, and life jackets and tosses it into the water, jamming the jet boat's intake and forcing the police to abandon the boat. Back on shore, Maria thanks them for their help and explains that her father isn't dead. The authorities put him in a mental hospital and leaked out word that he was dead so that there would be no protests. Maria refuses to abandon her father and Pete and MacGyver agree to help her rescue Alexander.
Maria takes Pete and MacGyver to the mental hospital. Maria drops them off and goes to the local village so she can gain access to the hospital later. Pete assumes the role of a Russian psychiatrist who brings MacGyver, his patient, to the hospital. Pete meets with Dr. Petrovich, the head of the hospital, and Dr. Suvarin, the political officer. He says that MacGyver is a schizophrenic and insists on observing him at all times. Suvarin turns down his request, warning that they do things by his rules. Suvarin takes MacGyver to Ward K where most of the political prisoners are kept, along with several who are really ill. The most outspoken patient is Yuri Demetri, who pretends to be insane whenever Suvarin challenges him. Another patient, a Chess Master, invites MacGyver to join him in a game. Suvarin takes away the board but MacGyver grabs it from him and starts running around the ward, acting insane. Suvarin has his orderlies subdue MacGyver, while Demetri recovers the chess board and gives it back to his friend. A hulking patient, Lopat, covertly helps MacGyver by clotheslining one of the guards.
Petrovich shows Pete around the hospital and he quickly realizes that she wants to cure her patients, unlike Suvarin. They get the report that MacGyver went out of control and Pete goes to see him. He explains that he's found the drug cabinet but it's locked and they only have one set of lock picks. MacGyver tells Pete to keep them and he'll come up with something else on his own.
That night, MacGyver asks Demetri finding Alexander for help and tells him his mission. Demetri is reluctant to help but the Chess Master informs MacGyver that Alexander is in Ward 0, directly above them. MacGyver uses the filaments from a light bulb as lock picks to get the door open then goes to Ward 0. There's a guard at the door so MacGyver goes into a nearby supply closet and covers a bucket with a caulking compound treated to act as glue. He lures the guard inside and the man picks up the bucket and ends up stuck. MacGyver goes through the door to Ward 0 but the guard sees him and manages to hit the alarm switch.
As the orderlies mobilize, Demetri and the other patients start a diversion. Lopat has followed MacGyver to Ward 0 and knocks out the guard. MacGyver thanks him and finds Alexander in a room by himself. More orderlies arrive and Lopat fights them, giving MacGyver time to get Alexander down to Ward K. Meanwhile, Pete gets the cabinet opens and steals several bags of drugs.
Suvarin and his men return Lopat to Ward K and he orders a potentially fatal drug treatment to calm him down. The Chess Master distracts him by rattling off the medical dialogue he knew in his old life. Suvarin vents his ire on the Chess Master by forbidding him from touching his chess set without permission. As he leaves, he almost spots Pete, who is forced to hide. Pete manages to get away unseen but Suvarin finds the drug packet on the floor. MacGyver comes back to the ward and claims he just wandered out during the chaos. As he distracts the orderly, Alexander slips into Ward K and Demetri hides him behind a bed screen. Once the orderly leaves, MacGyver explains the next part of the plan to Alexander: Maria has infiltrated the local village and has a job at the hospital as a kitchen worker.
Pete and Petrovich are discussing medical matters when Suvarin barges in and accuses them of working together to sell psychotropic drugs to the black market. He places both of them under house arrest.
The next morning, Maria arrives for her new job. Suvarin confronts MacGyver, figuring that if Pete is a fake doctor then MacGyver is a fake patient. MacGyver tries to pass himself off as an undercover KGB agent. When that doesn't work, the Chess Master knocks Suvarin out with his chess board, breaking it in the process. The other prisoners capture Suvarin's guards while Demetri takes MacGyver to Pete and Petrovich. They then give the stolen psychotropic to Maria, who slips them into the staff's breakfast tea. The staff starts acting loony and MacGyver and Pete bring Alexander in for a reunion with his daughter. They release all the prisoners and Petrovich agrees to go with Pete to America where she can practice medicine without government interference.
When it comes time for them to take Alexander out of the country, he refuses to go with them. Alexander believes that he needs to remain in Russia and bring about change from within. He asks his daughter to go to America so that she can't be used against him. Maria and Alexander say their goodbyes and Alexander goes to a park where the people celebrate his return.