It's Christmas in 1989 and the kids are arguing. Kevin calls Randall cheap. Randall says Kevin will be living in a box and Kate says her tummy really hurts. Then she's being wheeled into surgery to have her appendix out.
Rebecca hears Dr. K. and sees he's in a bed. He wrapped his LaSabre around a tree. When he says his family won't be there in time to "say goodbye," Kate realizes it's more than just a small accident. Jack and Rebecca decide they'll be his family, something Jack finds ironic, since they came together when Rebecca's doctor's appendix burst and now Kate's did the same.
Randall gets Dr. K. a snowglobe.
Apparently Olivia disappeared after Thanksgiving and never returned. Kevin's play is cancelled on Christmas Eve. Sloane is not pleased, and says Kevin owes her. Since he's responsible for her play being cancelled, he has to come to dinner with her.
While there, she tells the story of the holiday and Kevin is gobsmacked she's so good at it. He decides they don't need the others. They can put on the play themselves. They decide to do it.
Kate is at the doctor's with Rebecca. She's getting the final information on going through with the surgery. Rebecca cannot believe what she's hearing.
Kate doesn't much feel like doing Christmas Eve. When they get home, Rebecca wonders if she did this to her with the food. She never knew if she was talking about it too much or not enough. Kate honestly doesn't know. But she does wish someone would tell her she's doing the right thing.
Miguel gets the Christmas lights to work and they laugh.
William is sharing at a Narcoholics Anonymous meeting. He's talking about his son, and that taming the wildness inside allowed him to reconnect with Randall through all of the pain and joy it brought and he can spend Christmas with him so he can stay up late and watch Christmas Eve turn into Christmas day one last time.
Jessie begins talking about his issues, which are a bit more personal. It's about love and someone who left him. It's about William.
Randall buys a boat at the work party and Beth wants him to unbuy it. He heads out to find Andy, who is ready to toss himself off the roof.
Randall talks him out of it and they head home to their small family Christmas. But it gets bigger, as within 5 minutes, every other member of the family appears and brings a guest. Even Toby arrives, all the way from Cali.
Skipping back to 2009, Dr. K. makes it through surgery and is surprised to wake up.
Toby, on the other hand, is sweating profusely and falls to the ground. On the operating table, he seems unresponsive.