Contains spoilers for this episode and earlier episodes.
Flashbacks show Kate returning to her hometown under an assumed identity to visit her dying mother. Her childhood friend Tom, now a married doctor, helps arrange access to the hospital room. They also recover a buried time capsule containing a recording and his toy airplane. Kate's mother responds to her arrival by calling for help. Kate flees with Tom, ignores his pleas to stop and crashes while escaping police, leaving him unresponsive in the car.
On the island, Arzt warns that changing winds make the raft's departure urgent. Kate tries to secure a place, threatening Sawyer's position. Michael suddenly becomes ill, and Jack finds drugs in his water. Accusations turn first toward Sawyer and then Kate. Angry at losing his seat, Sawyer exposes Kate's stolen passport and forces her to admit she was the marshal's prisoner. Jack separately visits the hatch with Sayid and Locke and supports opening it, despite Sayid's objections.
Sun privately admits that she drugged the water to prevent Jin from leaving, accidentally affecting Michael instead. Jack agrees to keep her secret. Her subsequent conversation with Kate reveals that Kate suggested the plan, although Sun believes it was intended to help her. Walt denies poisoning Michael but becomes frightened when Locke touches him and warns against opening the hatch. Later, Walt confesses to his father that he burned the first raft. Michael offers to stay, but Walt now insists they leave.