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In the first flash back scene in this episode we see Kate entering a hotel room. She takes out a wedding vale from one of her many shopping bags. There is a loud bang on the door and a voice announces that it's the police. When she opens the door we see that Kate is engaged to the police officer and this is the night before their wedding.
The Others send Kate to see Jack to try to convince him to do the operation on Benjamin Linus, saying that if he doesn't comply they will kill Sawyer. Jack has them take Kate back to her cage. Jack manages to escape from his cell briefly, and he finds a gun and sees a CCTV image of Kate and Sawyer together in their cage, after they have made love. Ben walks in on him. Further confused and hurt, Jack says he'll do the operation on Ben if he is assured that when it's done he can get off the island. Ben is relieved.
During another flashback scene Kate is in the bathroom taking a pregnancy test, it's negative. She brings a drink over to her husband who is looking through a list of wanted criminals. She asks what he would do if he found out that she was also wanted by the police. He tries to get up but collapses, Kate reveals that she has drugged his drink and can't stay with him.
During the operation, though, Jack tells the Others that he has made an incision in Ben that will kill him in an hour. Outside Pickett decided that he is going to kill Sawyer in revenge for Colleen's murder. He puts the gun against his head when he hears his walkie talkie. Tom tells pickett that Jack is going to kill Ben unless he can talk to Kate. Jack tells Kate to run and to radio back when she is safe.
Eko follows the vision of his brother into the jungle which later turns out to be the mysterious black smoke we have seen in past episodes. The smoke hurls Eko through the jungle and kills him.