Tony Soprano jerks awake and stares at the ceiling. He’s still clutching the AR-10 rifle with stiff hands, lying on a bare mattress in the safe house. He starts sweating and feels a mounting, buzzing pressure. Panic attack. He puts down the gun and calls Dr. Melfi, oblivious to the lateness of the hour and the fact she had dismissed him out of her psychiatric practice only hours before. She answers, and Tony pleads his case, saying he absolutely needs to see her, lives depend on it. He goes on and on, Melfi staying silent. Finally, she slowly relents, and says they can meet in her office in forty-five minutes.
Meanwhile, Peter B. has managed to sneak his way into Silvio’s hospital room. Silvio lies on the bed in a coma, wires, tubes, and various devices attached to his body. Peter B. looms close, spits in his face, and shoves an ice pick deep into his throat. “Bada-bing,” he whispers.
Paulie Walnuts realizes Tony has left the safe house and makes a fateful decision. He calls one of the Italian guys, Vin Rizzo, and tells him to meet him at a bar near the Bing. “Bring some big fuckin’ tools,” Paulie tells him.
AJ is having his own miserable panic attack. He discreetly calls Rhiannon, speaking in hushed, imploring tones. “You’ve got to meet me!” he fiercely whispers. She agrees, and AJ leaves the house.
Paulie and Vin, using information coerced from Agent Harris (now missing three fingers) furtively scope out the nondescript house where Phil Leotardo is holed up. They see two guys unobtrusively standing guard and take them out with a silenced sniper rifle. Paulie is encouraged. “This one’s for Tone.” He and Vin plant C-4 charges around the house, back off and trigger the charges. An enormous explosion rocks the street and nearly knocks Paulie and Vin off their feet. Paulie looks at Vin. “Sorry to contribute to global warming, but fuckin’ sue me.”
Tony meets Dr. Melfi at her office. He immediately starts ranting about his current troubles. “You wouldn’t believe the shit I’m going through right now.” Melfi listens impassively. Tony pauses, and Melfi jumps in. “I’ve changed my mind. I don’t want to listen to you, and in fact am doing harm by allowing you to vent. I’m sorry.” She pulls a small caliber pistol out of her purse and shoots Tony in the face. Tony staggers up, clutching at his wound, and moves toward Melfi, but she shoots him several more times and Tony crashes into the coffee table and lies still, dead as a mackerel in the neighborhood deli.
Dr. Jennifer Melfi points the gun at her own temple and pulls the trigger. Nothing. No more bullets. She looks at the gun. She walks over to a cabinet, pulls out a box of ammo and reloads. She looks again at the gun, and leaves the office, intending to pay a visit to Eliot Kupferberg.
Carmela awakens to find Tony and AJ gone. She grabs Meadow. “Let’s find AJ and get the hell out of here.” They leave, call AJ, and meet up with him and Rhiannon at the pizza place where they were commiserating. They all get into the SUV and drive away. To New Jersey.