Holden comes upon Keith and Lily who are having a heavy discussion. Keith and Holden begin to spar verbally, and Lily asks Keith to leave. Keith does so, reluctantly. Lily feels some responsibility for Keith's taking the organ transport job since he owed her money. She tells Holden that she no longer has romantic feelings for Keith, however.
Hal wants to know from Emily why Paul has been footing the bills for Gwen's expenses. Em tells him it was for Will because he was so attached to Gwen. Hal keeps on hounding her about the lawyer's expenses until Emily finally blurts out that the situation also involves Jennifer. Emily hints that Paul is paying for Gwen so that she will leave town with the baby and Jennifer will stop obsessing that the baby is hers. Hal isn't buying that story either.
In New York, Gwen lies unconscious at the foot of the park stairs. Carly flashes back to when Iris' baby "died." Iris tries to comfort Gwen, and calls her her "little angel." Iris also tells an investigating policeman that she is Gwen's mother. Carly suddenly realizes that Gwen is the baby that Carly supposedly killed as an infant. Iris' baby was not a boy but a girl!
Paul sits down next to Meg on the plane to Florida. He expresses his concern about Jen's mental stability while at the same time he pumps her for information. Meg tells Paul not to worry that Jen is delusional because she has the proof that Jen is right; the baby Carly is raising is Jennifer's by virtue of the blood tests done. She shows Paul the paperwork and slowly realizes that she is not telling Paul anything he doesn't already know. She is stunned that Paul has known all along and not told Jennifer. Why is he playing God?
Emily next tells Hal that Paul wanted the baby to go away because he is a reminder of Rosanna that Paul cannot bear. Barbara shows up and begins her usual harangue at Emily. Hal gets a call that Jack has found Gwen, Will and the baby.
The EMTs arrive for Gwen and she begins to regain consciousness. They transport her to the hospital, and Iris and Will ride along in the ambulance. Jack and Carly decide they want baby Rory checked out after his wild carriage ride, so they head to the hospital as well.
At the hospital, Rory is fine, and Carly realizes she has remembered about Iris' baby. Carly confronts Iris at the hospital and Iris retreats to the cafeteria. Gwen wakes up fully with a terrible headache and is upset that "Billy" is back with Jack and Carly. Will stays with her in her room to comfort her.
Dusty and Jennifer are disappointed that Nurse Tompkins did not show up for their appointment. Dusty says it is time to go to the source of the baby switch: Craig. Jen cannot bear to face Craig; she is afraid she will try to kill him. Dusty persuades her to give it a try to calls the prison to set up a visit as soon as possible. Within a few minutes, however, the prison calls back with the news that Craig has declined such a visit. Jen breaks down and Dusty tries to comfort her by holding her. They talk seriously, then kiss, and then begin to make love.
Jack and Carly suddenly realize that if Gwen is the baby that Iris had with Ray Tenney, then Carly and Gwen are half-sisters. Carly wonders if Gwen knew that all along and wants to confront her.
Paul follows Meg to the hotel where Dusty and Jen are staying. Meg tells him that she has decided to go home and will leave the decision about telling Jen her baby is still alive all to him. She hands Paul the envelope from the hospital containing the blood test results and leaves. She still has some papers in her purse, however.
Lily gets a call from Luke who is still not feeling well. Holden says he would like to go home with Lily, and she agrees. As they leave, Keith lurks in the shadows.
Paul calls Emily and tells her that Meg is on board and will not tell Jen about the baby. As he is talking, he opens the envelope Meg gave him and finds a piece of paper with "GO TO HELL" written on it. He hangs up hurriedly and dashes out.
Meg finds the door to Jen and Dusty's room ajar and looks in. She sees the couple on the bed, making love.
While Jack hopes for the best now that the secret about Gwen and Carly being sisters has been exposed, Carly faces the young woman who's been her worst enemy over the past few months and dares her to pretend she hasn't known the truth all along. But Gwen insists she didn't know and Carly soon sees Iris has lied to her own daughter as well. But despite the new genetic bond Gwen and Carly share, neither seems any closer to resolving things where the baby is concerned. Paul is furious that Meg gave him the slip when she handed over what appeared to be proof Jennifer's baby is still alive. He follows Meg to Jennifer's hotel room where a heartbroken Meg has just witnessed Jennifer and Dusty's passionate embrace. But, when Meg overhears Jennifer stop Dusty and say she can't truly move on with him until her baby is found, Paul sees an opening and convinces Meg to keep the secret. Still, Meg doesn't like herself for the deception and when Paul applauds her shrewd thinking, she tells him to go to hell and Paul is left to wonder how much of a threat Meg really is. Katie meets Mike at Fairwinds, unnerved when she learns that not only has BJ bought the place but he's enlisted Mike to help renovate it as well, thus keeping him and Katie apart even more than they already are. But, Mike assures her that he and BJ had a heart-to-heart about his intentions where Katie is concerned and there's nothing whatsoever to worry about. Katie starts to think she might have been overreacting until later, BJ sees Margo with two cops in tow and bolts from the house with no explanation.
Carly wants to press charges against Iris for what she did to her, but Tom tells her that the statute of limitations has run out on what Iris did when Carly was a child, and she has no real case. Later, Jack sees the vendor and learns from Margo that he has testified to Carly's drugging Gwen in exchange for immunity. Jack is forced to put Carly under arrest. Iris talks to Cass, who tells her they have a good shot at getting the baby back now that they have a strong case against Carly. Iris tries to convince Gwen that she will help her get her baby back but an angry Gwen doesn't believe her. Iris then takes Gwen to the police station to see Cass at work on her behalf. Just as Carly is about to be taken to a jail cell, Cass presents her with a subpoena to appear at a hearing later that day to determine custody of the baby. BJ explains his sudden disappearance at the sight of the cops. He tells Mike and Katie that he had a bad experience with policemen when he was young. He ruins Mike and Katie's lunch plans by sending Mike to an appointment, then suggests Katie have lunch with him. At the lunch, he talks to Katie about a housewarming/Halloween party he wants to throw. They discuss high school and when she tells him about some nerd who helped her with prom decorations, BJ insists he was that guy. Katie takes it metaphorically. She's disarmed by his modesty and agrees to help him with his Halloween party, which he wants to turn into a high school themed costume party. Maddie tries to impress Casey and Lia by telling them she's moving in to a mansion and takes them to Fairwinds. They are unimpressed and leave. Alone, Maddie looks around and finds a hidden box with a cheerleader's costume inside. BJ arrives and she says she knows who he is, just as Katie walks back in the room.
While an emotional Meg reels from what she witnessed between Jennifer and Dusty, Dusty pushes his feelings for Jennifer aside as he comes up with a new plan to prove her theory about her son being alive. Paul realizes Dusty must be put out of Jennifer's life for good and dispatches Emily to handle Meg while he deals with Jennifer. Paul guilt-trips Jennifer and starts to lay the groundwork to drive a wedge between her and Dusty only to get the shocking news that Dusty is planning on a second blood test. Meanwhile, Emily ties to reinforce to Meg that by keeping the baby switch a secret, she is helping her relationship with Dusty. Meg is sickened by Emily's reasoning and tries to pull away, as Dusty enters to see the heated exchange. While Mike returns home and plans a romantic encounter with Katie, Maddie nearly tells Katie the truth about BJ but pulls back and covers in fear of BJ. Later, Katie and Mike share a romantic interlude and Katie admits she may have misjudged BJ, even as BJ threatens Maddie to keep her mouth shut about his identity or pay the consequences. Ultimately, Maddie agrees. Holden comes to pick up Lily for a date and Luke, though weak and not feeling well, is thrilled that his parents are working towards getting back together. He goes out with some friends and runs into Keith, who begs him to tell Lily that Mexico was not his fault. Seeing how sick Luke is, Keith takes him home where Lily rails at him once again for interfering in her family's life. As the conversation heats up, Luke suddenly collapses to everyone's shock and horror.
Dusty approached Meg and Emily at the hospital and asked Meg if Emily was bothering her. He got Emily to leave and then asked Meg to help him find out the truth about Jennifer's baby. Meg asked how much he and Jennifer had already found out, and he told her not much, but that if they could have a blood test done, they could resolve this whole issue and prove that the baby was Jennifer's. When Meg realized that Dusty was only being nice to her because she could help him do something for Jennifer, she decided not to tell him about the DNA results that she already had in hand.
Paul tried to convince Jennifer that Dusty was not the person she should be relying on to help her prove her baby was still alive. He told her that he would help her instead if she would just let him. Emily then called Paul from the hospital and told him she was afraid Meg was getting ready to tell Dusty the truth, so Paul rushed over to the hospital, leaving Jennifer at Java with Barbara, who had walked in while they were talking. Barbara told Jennifer that Will was in trouble because of Gwen kidnapping the baby; Jennifer was very concerned to learn that the baby had been taken to New York by Will and Gwen and wanted to know where the baby was right now. Barbara said she assumed he was with Carly and Jack, but she wanted Jennifer to go to the custody hearing with her so she could try to talk some sense into Will about being involved with Gwen and the baby. Jennifer said she couldn't go right now because she had to take care of something more important, and she rushed off to the hospital to find Dusty, Paul, and Meg.
At the hospital, Paul cornered Meg after diverting Dusty's attention by faking a phone call to him from Jennifer (which Emily actually placed instead). He tried to convince Meg that it would be in her best interests to fake the blood test and convince Jennifer that she was wrong about her baby being alive, because then, Jennifer would hate Dusty for having led her on in her belief that her son might be alive, and with some help from Paul, Jennifer would want to break things off with Dusty entirely, leaving him open for Meg to date. Meg couldn't believe that Paul could continue thinking this was best for his sister.
When Jennifer got to the hospital, she was hysterical and told Dusty, Paul, Meg, and Emily that her baby wasn't safe with the people who were taking care of him and that they needed to get the blood tests done right now, so that she could get her baby back. Dusty tried to calm her down, and as they watched Dusty and Jennifer embrace, Paul took the opportunity to again try to persuade Meg to not tell Jennifer and Dusty the truth. Meg then told them all that she was going to perform the blood test, to help Jennifer find the truth.
Holden and Lily rushed Luke to the hospital, where Susan ran several tests to try to find out what was wrong beyond the obvious infection that he had. Keith came, too, trying to ensure that Luke was going to be okay. Holden and Lily both apologized to him briefly for not believing him when he said that he thought Luke was still seriously ill. Then Susan returned and asked to speak to Holden and Lily. She told them that Luke's kidneys were shutting down and that he needed specialized help or he would die; she told them he would have to be moved to St. Paul, where he could undergo dialysis and see a pediatric specialist. Lily was stricken to hear that Luke might actually die, although Holden assured her that wouldn't happen. Keith overheard Susan telling Lily that Luke needed to get to St. Paul as soon as possible, and he offered to immediately fly Luke up there, but Lily turned on him and angrily said none of this would have happened if it hadn't been for him and that there was no way she was ever going to let him have anything to do with Luke again. Holden then arranged to have Lucinda's corporate jet take Luke to St. Paul, and Susan arranged for a MedEvac helicopter to take him to the airport. Emma arrived suddenly at the hospital, having had a premonition that something was very wrong, and she told Lily that both she and Holden should go with Luke to St. Paul, and that she would take care of Faith and Natalie for them.
Before the custody hearing, Will told Gwen he was concerned about her health because she looked like she was about to pass out and she hadn't stayed at the hospital to have the MRI they wanted her to have. She assured him she was okay and that she could make it through the hearing. In the courtroom, Carly told Jack she thought she had a way to turn everything around and win the custody case, but Jack tried to convince her that her best option was to try to work things out with Gwen. She disagreed and refused to try. Jessica came in and told Jack and Carly that Cass had managed to get a new judge assigned to the case. Gwen and Will came into the courtroom, followed by Iris and Cass Winthrop. Gwen had already told her mother that she didn't want her to come to the hearing, but Cass said he had insisted she be there because it would help Gwen's case if the judge could see that she had extended family who could help her with the baby. When the judge came in, Carly insisted that she had to make a statement, and the judge decided to give her 1 minute. Carly tried to explain about Iris having falsely accused her of murdering a baby boy, only to recently find out that the baby had been Gwen, and that they were sisters. The judge said he didn't believe in listening to grown adults make excuses for their behavior based on their childhoods. He then stated that he had decided that the baby was to be removed from the Snyder's care, and Gwen assumed that meant she was going to get custody, especially when the judge said he was going to recommend to Tom Hughes that no charges be pressed against Gwen and Will for kidnapping the baby, because he could understand what motivated her to do so and because she gave the judge her assurance that she'd learned her lesson and wouldn't do anything like that again. But the judge stunned everyone by saying that he had decided not to award full custody to Gwen either.