Shane runs into Amanda at the Harbour Club and apologizes for running out on her. When he mentions that Amanda may be as upset about Jake and Vicky's wedding as he is, she scoffs at the idea she has feelings for Jake. Felicia and Alexander arrive and Felicia still has a funny feeling about Amanda. She wonders aloud if Carl may be using Amanda to get back at Alex (little does she know its the other way around). Both Felicia and Amanda tell Cass that Carl was irrational about Alex and wonder if Rachel may be able to talk some sense into him. Amanda continues her plan to make it seem as if Carl is unfaithful by buying an expensive gift for Hadley Prescott. Chris tries to calm the jittery bridegroom who still has doubts about Vicky's feelings for Shane. Jake begins to dream about the wedding which went beautifully until he imagines Shane arriving and Vicky leaving with him. Jake gets more and more worried the later it gets and that he can't reach Vicky by phone. As a nervous Jake waits in Lassiter with Chris, Donna and Michael, Vicky chases an angry Kirkland who has taken off on his bicycle after a fight with Steven. Paulina, jittery and high on her diet pills, speeds down the country road toward Vicky's house. She swerves the car when she sees the cake falling, just as Kirkland rides into the road. Vicky watches in horror as Kirkland was hit by the car which ends up in a ditch. She rushes to her son as Steven runs up. Vicky orders him to call 911 and to see if the driver was hurt. He told his mom the driver was Paulina. In the ER, John tends to Paulina while Shane tends to Kirkland. Vicky begs him to save her little boy. A grim Shane told Vicky that Kirkland has suffered severe head trauma and was on a respirator. Steven blames himself but Vicky assures him it wasn't his fault. She asks Steven to call Jake while she went to be with Kirk. Steven doesn't seem to call Jake on the phone but just whispers for Jake to come home now because they need him. Paulina regains consciousness and starts freaking out when she realizes she ran over Kirkland. She gets very agitated and John was almost forced to restrain her. She freaks out again when Emily mentions that Joe has been alerted of the emergency. John coldly asks if she's been taking any pills as Paulina continues to act crazy and orders a toxicology screen.
Amanda continues her plot against Carl by spraying his jacket with "Hadley's" perfume and then placing a gift supposedly from Carl to Hadley in a place where Rachel will find it. Rachel comments on smelling the same perfume on Carl's clothes recently and was noticeably upset when she finds the gift. Amanda of course, plays on her insecurities and suspicions before she leaves the house. Josie (in disguise as some military cadet) and Toni discuss their plan, not knowing Rayburn was on to them. Josie was wearing a wire which was supposed to keep her connected to Toni her backup. Josie goes to the bar where Rayburn was drinking and watches him through a window. Meanwhile, at the hospital, Vicky and Jake are overjoyed when Kirkland opens his eyes. A distraught Paulina sneaks out of her room to check on the boy and was relieved he was unconscious. But she was still hysterical and insists it was all her fault, despite Vicky and Jake's remarks that it was an accident. John orders Paulina back to bed and told her she had better tell Joe about her problem or he will. Paulina, in tears, admits to Joe that she has been taking the diet pills and that she can't stop. He tries to offer his support but she insists she can't get by without another pill. When Paulina hears John and Joe discussing drug rehab possibility (b/c the drugs Paulina has been taking are heavy duty speed-type drugs which are easy to become addicted to), she runs out of the hospital. They chase her outside but before they restrain her, she bumps into Toni, somehow busting the wire that connects her to Josie. Joe and John carry a screaming, hysterical Paulina back into the hospital while Toni worries about losing touch with Josie. Of course at that moment, Rayburn leaves the bar and Josie goes after him, not knowing she has lost her backup. Rayburn attacks Josie from behind. Vicky wonders why Shane still seems so solemn and he explains that he found a congenital aneurysm in Kirkland's brain which Shane feels needs to be removed. John offers that he believes Kirkland may be fine without the operation but agrees that there was a chance that the aneurysm could rupture and cause death. Vicky struggles about what to do - especially since Grant can't be reached. Shane informs Vicky that he has performed the operation before and will have assistance of a renowned specialist - which seems to be a relief to Vicky but upsets Jake. Vicky says she needs to think about things first and went to see Kirkland. The little boy doesn't realize anything was wrong and apologizes for ruining the wedding. Jake and Vicky "get married" in the hospital room, saying their vows in front of Kirkland with the boy concluding "to death do us part."