After an extended "Previously on 'Six Feet Under,'" the episode opens in the operating room. Nate's surgery hits a bump. Title card reads: Nathaniel Samuel Fisher, Jr. 1965-2002.
Flash to the Fisher home. Federico sits despondently in the morgue, Claire in her room. Ruth irons. David cries at his desk.
Flash to a restaurant. Nate watches his father eat a goopy mess called fenugreek. Nate urges him to hurry; he doesn't want to be late for his funeral.
At the Fisher home, Nate observes his funeral. He looks at himself and at David, who is by the casket. He tells David he wanted to be cremated. Suddenly, the funeral vanishes and Nate hears David patiently pronouncing words. He discovers an impaired version of himself (perhaps the operation had gone wrong) trying to mimic David -- and failing.
The dream changes again, and Nate discovers he and Lisa, playing with their baby girl and talking about dreams. Then, Nate watches as he and Brenda come through the front door, and Brenda is holding their son. Another change, and the whole family -- including Dad -- is having Christmas dinner and talking politics.
The real Nate runs back to house's entry hall and confronts his father about what is going on. He asks if he is alive or dead, if he is in heaven or hell. Nate Sr. says that he is alive in some places, dead in others, and sometimes even non-existent. Nate Sr. tells his son to open the casket. Nate does.
Title card: Nathaniel Samuel Fisher, Jr. 1965--
It is seven months after the operation. Nate is alive and well, attending a friend's barbecue. He and Lisa are married. Holding his daughter, Nate explains to his friend what happened with his operation. His head nearly exploded, but he got lucky and survived.
Over dinner, everyone chats and Nate has a déjà vu flash -- someone has mentioned the word "fenugreek," which was the goopy stuff his dad was eating in his operation dream. Nate and Lisa then bid everyone goodbye.
David and Keith are in a couples therapy session. David is trying to describe how he feels about Keith's anger issues. David says he is constantly editing himself because he's afraid of pissing off Keith. Meanwhile, Keith is frustrated with his job as a home security officer.
Claire is in art class, drawing a nude male. The teacher looks at her work for a long time, then moves on to the next student and compliments him.
Nate and Lisa come home and find Ruth there. Nate has another flashback to his operation dream. Carol Ward, Lisa's boss, drops by. She reminds Nate not to park in the driveway and acts very tyrannical and sarcastic.
Federico calls Nate and reminds him there are two viewings that day, but David is nowhere to be found. Federico says he is a partner, not an employee, and a licensed funeral director.
At the Fisher home, David asks Claire about art school. Claire responds rather indifferently. Nate comes by with Maya. The brothers don't have time to drop off a body at the crematory, so they offer to pay Claire to do it. She agrees, but has to do homework first.
Claire practices drawing a perfect circle by hand, but doesn't seem to get very far. She drops the body off at the crematory, where she flirts with a guy named Phil. He's in a band, and he asks her to stay to watch them practice.
At Carol's house, Lisa prepares some food. Carol purports to be amazed by Lisa's energy level. Lisa talks about how much her life has changed thanks to Maya, and Carol bursts into tears. Then, she angrily tells Lisa that she is sick of not being able to swim in the nude because of Nate.
David and Keith cook dinner. David accidentally puts in pepper, and Keith chastises him. David tries to use therapy-speech to express his feelings. Keith opens up, and says that he feels he can be angry with David because he is so comfortable around him.
Ruth is babysitting Maya. As she feeds the baby some peanut butter, she reminisces about her own children. Apparently, Nate wasn't planned. Nate overhears this, but doesn't let on when he comes into the kitchen. Ruth enthusiastically offers to take Maya for a night, so Nate and Lisa can have some time off. An exasperated Nate declines.
David and Keith get ready for bed, and Keith asks if they're having sex. David agrees but wants to take a shower. But by the time he gets back, Keith is fast asleep.
Claire wakes up in Phil's bed. He gives her some coffee and convinces her to ditch class.
At the Fisher home, David and Nate have a heart-to-heart. David confesses he and Keith are seeing a therapist. David notes that a year ago, Nate was engaged to Brenda and now he is with Lisa. Nate says that you never know what life has in store for you. David confesses that he is trying out for the Gay Men's Chorus, and Nate wishes him good luck.
As Lisa folds laundry, she notices an odd stain on the baby's clothing. She calls Ruth and asks her if she fed Maya peanut butter, which young babies shouldn't eat. Ruth apologizes, then offers to come over to help. She is being very needy. An exasperated Lisa declines.
As David tries out for the chorus, Keith checks in at a home, where the "emergency" turns out to be a dead rat in the pool. Meanwhile, Ruth goes hiking and Nate comforts a griever.
Later, Nate comes home and talks to Lisa about learning he wasn't planned. He tells her, "I don't like knowing my whole existence is random." She replies that things happen the way they're supposed to, but Nate isn't sure if he likes that idea. They lay on the bed with the baby, and continue talking. Nate flashes back to his dream. They are having the exact same conversation as in the dream. Nate tells Lisa he dreamed this moment and their life together.