Jack woke up from his blackout, still looking a little shaken. He walked in on a big argument between the castaways and the strangers from the boat. He encouraged everyone to be patient, and passed out again.
Flash forward: Jack woke up looking happy, tripped over a kid's toy in the kitchen as he went to make some coffee, but didn't seem to really mind. Then he walked into the bathroom where ... wait for it ... Kate was taking a shower! The seemingly happy couple kissed as they greeted each other, "Good morning."
Jack read Aaron to sleep as Kate watched and smiled. (Didn't Jack say he never wanted to see the kid? So, is this before or after he said that?) Kate told Jack she loves seeing him with the kid and that she was so glad he changed his mind, but about what? About seeing the kid? Or about something else?
Back on the island: Jack woke up again and was still struggling, but insisted he just needed to get some rest. Sawyer, Claire and Miles made their way back to the beach and Claire said she still had a bit of a headache but at least she wasn't seeing things anymore. (Ever stop to wonder how Clarie survived her house blowing up so easily?) Just then, Miles (who we've seen has some kind of connection to the dead) got a flash of Karl and Danielle, and realized he was standing on their very shallow graves.
Jack told Juliet that he thought he might have food poisoning, but she figured out it was his appendix. They'd have to take it out. Juliet asked Sun to go to the medical hatch and get a list of things needed for Jack's surgery. Daniel volunteered to help Sun identify surgical instruments, but everyone still questioned whether they could trust the people from the boat. Juliet decided to let Daniel and Charlotte help, but handed Jin a gun and told him to shoot them in the leg if anyone tried to take off.
Rose wondered if Jack had done something to upset things on the island, because she was convinced that people don't get sick on the island, they get better. Jack gave another glimpse into his control issues by insisting that he remain conscious throughout the procedure so he could talk Juliet through it.
Flash forward: Jack saw a vision of his dad walking through his hospital's lobby, then got a message to go see Hurley, who wasn't taking his meds in the mental hospital. Hurley told Jack he stopped taking his medicine "because we're all dead." He believed that the Oceanic Six were all dead because everything that was happening was too perfect. Hurley had a message for Jack from Charlie, "You're not supposed to be raising him," then asked, "Do you think that means Aaron?" Jack got upset, said that didn't make any sense, and Hurley told Jack one more thing: Charlie said someone's going to be visiting you too -- soon.
Back on the island: Sun, Jin, Daniel and Charlotte found the medical hatch and Sun told Jin in Korean that she doesn't think the boat people are going to help him. Charlotte kept looking at the couple as they talked. Does she know Korean? Meanwhile, the helicopter pilot ran into Sawyer, Miles and Claire and warned them to hide because Keamy (the scary boat commander guy with the assault rifle) was coming around. There was a tense moment as the group hid and Keamy thought he heard Aaron make a noise, but it passed when Lapidus kept urging Keamy to move along because he (Lapidus) wasn't going to fly at night.
Back to the future: Jack was still bothered by what Hurley said. He asked Kate if she really thought he was "good at this." Then he asked her to marry him, and she said yes.
Back on the island: The group came back from getting the medical supplies and Jin confronted Charlotte about the fact that he knew she understood Korean. After he threatened to hurt Daniel if she continued to lie, she started talking to him in Korean and asked him what he wanted. He said he wanted her to make sure that Sun is on the helicopter when it came to get her.
As Juliet performed the appendectomy, Jack started to struggle with the pain and she finally demanded that Bernard knock him out against Jack's wishes. He did.
Back to the future: Jack was looking at X-rays in his office when he heard a beeping that drew him to the lobby and he again saw his dad. This time, his dad called out his name. When a colleague walked in, Jack snapped out of it, no longer saw his father, and asked the fellow doctor to write him a prescription for something to help reduce the stress he'd been feeling.
When he got home, Jack heard Kate talking to someone named Noreen. Kate said she was a mom from the park. Jack hadn't heard of this person and seemed suspicious of Kate. He popped a couple of pills and downed them with a beer.
Back on the island: Sawyer and Miles slept around a fire when Claire woke up looking for Aaron and saw her dad (and Jack's dad), Christian holding him.
Juliet stitched Jack up when Kate walked in and thanked Juliet for saving him. Juliet told Kate that Jack had kissed her, but that it wasn't for her it was for him. He was trying to prove he didn't love "someone else." Kate thanked Juliet, seemingly for telling her this, but after a pause, Kate said, "For saving Jack's life." When Kate left the tent, Juliet told Jack she knew he was awake, and he opened his eyes after having heard the exchange between Kate and Juliet.
Back to the future: Jack had been drinking when Kate got home late. He demanded to know where she was and she asked him to just trust her and leave it be. But he wouldn't, and she confessed that she was doing something for Sawyer. Jack got upset and asked what it was, but she wouldn't tell him that because Sawyer wouldn't want her to tell Jack. Jack said Sawyer "made his choice, he chose to stay. I'm the one who came back. I'm the one who's here. I'm the one who saved you." Kate told Jack he needs to deal with his problems because she can't have him "like this around my son." He snapped at that, saying, "you're not even related." Kate picked up Aaron, who had wandered into the room, and she began crying.
Back on the island: Sawyer woke up and found Claire was missing. Miles said she walked into the jungle with someone she called "dad." Sawyer heard Aaron crying and found him lying in the crook of a tree in the jungle, but Claire was nowhere to be found.