After Leaping, Sam finds himself in a man who is strapped to a gurney in an psychiatric hospital's shock theater for electroshock treatment in 1961. The male nurse, Butch, refers to Sam as "Sam Beederman," punches Sam, and says that nobody hits him and gets away with it. The female nurse, Chatam, comes in and realizes that Butch plans to get revenge by giving Sam electroshock. She tells Butch to wait while she summons Dr. Masters, but Butch ignores her and shocks Sam.
After four hours in recovery, Sam is taken back to the patient ward, at what is the Havenwell Mental Hospital. One of the patients, Libby, realizes that Butch tried to kill Sam, but then says that Sam isn't Beederman. Butch figures that it's just Libby acting insane and ignores him. Once the nurse is gone, Tibby tries to warn the stunned Sam that no one will cure him and that Butch wants him dead. Chatam arrives with an orderly, Freddy, and they check on Sam. Freddy is worried that Sam has been deteriorating since he was admitted, and Chatam figures that Sam needs their help.
Al arrives and tries to get through to Sam, explaining that he'll get to use his first name. Sam doesn't seem to recognize Al, who has Dr. Beeks working on it as well as analyzing Beederman, who is in the Waiting Room and suffers from clinical depression. When Chatam promises that she won't let Sam undergo electroshock therapy, Al realizes what happened and assures his friend they'll work out what he has to do so he can Leap. Sam talks to thin air, not entirely surprising Chatam, while Tibby tells her that Sam isn't Beederman and that there's another man, Al, in the room.
Dr. Masters arrives to check on Sam, who tries to explain that Al is there. The doctor assumes that he's having hallucinations, while Al tries to explain to the confused Sam what is going on. Sam suddenly starts acting like a woman, and says that he's Samantha Stormer, who he previously Leaped into. He explains that he's a secretary in 1961 in Detroit and is locked up because he hit his boss, Buddy Wright.
Sam rambles on as Dr. Masters observes him with interest. Al tries to get through to the real Sam, who vaguely remembers Sam Beckett as a boy he knew in Elk Ridge, Indiana. When Tibby tries to tell Masters what is going on, Al warns him not to say anything or they'll lock him up for good. Masters concludes that Sam is suffering from multiple personality disorder and orders him put into an observation room. Before they can take him away, Sam asks for the chance to rest.
Once Al is alone with Sam, he tries to explain about their friendship and how Sam brought him onto Project Quantum Leap, and that he's a hologram. The other patients in the ward can also see Al, and he realizes that their disturbed brainwaves are in sync with the proper frequency. Sam dozes off and Al avoids Tibby's questions about the future and goes to talk to Gushie.
Masters considers Sam's case with Chatam and believes that his patient has spontaneously developed a new mental illness. He wants to use sodium amytal on Sam and dismisses Chatam's concerns when she suggests that he's letting his enthusiasm overcome his ethical responsibilities.
Al returns and tell Tibby that Sam was supposed to have Leaped to the hospital to get Tibby out. Now Al has to fulfill the mission, and confirms that Tibby has a mild form of Down's Syndrome. Due to that, he'll be released during budget cuts and die on the streets. When Sam wakes up, Al explains that they have to help Tibby gain enough knowledge so that he can read and get a job. Freddy the orderly comes in to take Sam to the observation room, and Sam now believes that he's Jesse Tyler, the black chauffeur he Leaped into during the 1950s. "Jesse" thinks that he's being punished for sitting at a diner counter. Al starts to flicker in and out and warns that it's taking full power to maintain the connection during Sam's personality shifts. He warns his friend that he doesn't stop switching, they could lose contact forever.
As Masters examines Sam in the observation room, Al reappears after they reroute power. Meanwhile, Chatam is explaining to the observing doctors that Sam believes he's a black man in 1955. Sam sees an ink blot that reminds him of the blood on Jesse's granddaughter when she was injured, and remembers taking her to a whites-only hospital. Al tries to remind his friend that he has a medical degree and Sam argues that he can't read, further convincing the doctors that he is delusional. Sam finally agrees to finish the Rorschach test and starts to remember his background as a physicist. However, when Butch comes in to bring Sam some water, his presence triggers another personality switch. Sam becomes "Magic" Williams from his Vietnam Leap and accuses Butch of being a VC. A desperate Al manages to convince his friend to ask Masters to take him back to the ward.
Once they're away from the staff, Al tells Tibby that he has an idea how to teach him how to read. He pulls up a rap song and makes up alphabet lyrics, teaching Tibby how to read by getting him to sing. The other patients, who can all see Al, join in. Sam wakes up, but Al soon realizes that he believes he's Captain Tom Stratton from his first Leap. As Tibby learns how to read, Al confirms that history has changed and Sam can Leap, but disappears due to another power loss as Sam remains where he is.
Sam dozes off and has vague memories of his Leap home into his teenage self and Kid Cody. Al returns, explaining that Ziggy was able to divert ten minutes of emergency power. He has Dr. Beeks with him and holds her hand so that Sam can see him through the mental connection. Al relays Beeks' advice that since Sam underwent shock treatment, Sam's ego was temporarily indisposed and his memory fragments of prior Leapees are filling in the gaps. Beeks disappears when the power loss becomes critical and Al tells Sam that he has to undergo another bout of shock treatment to undo the fragmentation. Sam violently objects but Al insists that he has to do it or Sam will be trapped forever.
In the hallways, Butch finds Chatam and warns her that if she tries to blame him for the unauthorized shock treatment, he'll take her down with him. The angry Chatam goes to the observation room where Masters is now interviewing Sam in his persona of the childlike Jimmy LaMotta. Masters suspects that the shock treatment may have reverted Sam to an earlier age when he suffered a childhood trauma, but nothing in the files indicates what. Al arrives and tells Sam that he has to ask for another shock treatment. Sam gives in and goes violent to provoke them. Butch confines him and Masters orders another round of shock treatment, ignoring Chatam's objections.
Back in the shock theater, Butch straps Sam to a gurney. While Sam begs Al not to leave him, Chatam objects to the procedure but Masters ignores her, determined to cure or analyze Sam. Al tells Sam to tell Masters and the others to administer the precise charge. Masters asks who administer the charge and at what dose, and Chatam finally admits that Butch administered the treatment. While the doctor rounds on Butch, Sam begs Chatam to turn the switch at the precise setting. Taking pity on him, Chatam throws the switch... and Sam and Al both Leap.
Sam wakes up in a park, lying on the grass. He's able to think again as himself, but is surprised to see Al lying on the ground. When Al wakes up, he confirms that he is wearing a soldier's uniform, but discovers that his hand link doesn't work. Al realizes that he's solid, and Sam walks straight through a cannon and discovers that he's a hologram.