The stress of Britten's predicament is starting to wear on him. Though each incident seems relatively minor, Britten begins to confuse which case he's working on in each world. He talks to Vega as if Vega is his partner in the reality where Bird is his partner. At a coffee shop, he mistakenly orders Rex's drink while Hannah is with him and vice-versa. Those around Britten cannot understand why he's so scattered while he's desperately trying to keep both states straight.
Britten and Vega investigate a hostage situation at a mental hospital. A paranoid, schizophrenic patient, Gabe Wyath III, has escaped from his room, taken over the building and threatened to blow it up. Taking the first call from Gabe, Britten tries to earn his trust by asking what he wants. Gabe says he needs to see his sister. Britten asks for a little time, but Gabe hangs up. A staffer informs Britten that Gabe's sister Christy died four years ago.
While the SWAT team devises a strategy to neutralize the Gabe situation, Dr. Lee, who works at the hospital, fills in the cops on his condition, while keeping his relationship with Britten confidential. Gabe was once a rising star in a government research lab before his schizophrenia worsened. After Christy's death, Gabe created a delusion where she was still alive and held captive by agents of the lab in a secret location. Dr. Lee determines Gabe can't be reasoned with - as long as he's letting something only he can see dictate his actions - a comment that's not lost on Britten. Gabe has taken over the hospital's command center, so he's able to use all the stuff that keeps patients inside to keep the cops out. Since it will take 12 - 14 hours to set up a full breach, SWAT wants to set up a sniper to take Gabe out... but to execute their plan, they need someone inside the building to lure him into the line of fire. And the only outsider Gabe will allow into the building is Britten.
Once inside, Britten is unnerved by the mental patients wandering through the halls of the institution. Gabe wants to know if the cops told Britten that he's making up the story about his sister - because that's how they discredit a person. His sister tried to protect him, but the government abducted her and took her to an underground facility. Gabe only wants to see her again. He hands Britten a photo of the two of them in happier times, which has the words "Trip 07" written on the back. Gabe informs Britten he's holding a dead man's switch in his hand. If for any reason Gabe lets go of the switch, the explosives will ignite. It's how he's going to keep "them" honest. Britten now realizes the sniper plan won't work, but he has no way of informing his team.
As Gabe continues sharing his fantasies, he inches nearer and nearer to the sniper's vantage point. Britten's ears perk up once Gabe mentions a Dr. Wild being the head of the group responsible for kidnapping his sister. "Wild" was also the word on a brass ring that went missing from an evidence box in Rex's world. Before Britten can process the connection, Gabe wanders too close to the window, and Britten is forced to tackle him out of the path of the sniper's bullet. Completely unglued, Gabe knocks Britten across the back of the head with a pipe. When Britten comes to, Gabe is standing over him with a giant syringe of anesthetic, which he plunges into Britten's belly. It's not long before Britten wakes up at home in his bed with a green rubber band around his wrist - he's in his other reality!
Britten hopes to be able to solve the case from "the other side." If only he could find that missing brass ring! He's so deep into it, he has no idea that Rex's girlfriend Emma has spent the night. The search comes to an abrupt halt when Britten notices a penguin standing in his kitchen. Fearing for his sanity, Britten visits Dr. Evans, who explains the hallucinations associated with certain anesthetics, like ketamine. Britten won't admit to "seeing things," despite the fact that the penguin has accompanied him to Evans' office. Evans is fascinated to learn he's having a fantasy where he's helping a schizophrenic in a mental hospital. She believes Britten is having this dream because somewhere inside, he realizes if he doesn't come to terms with his own reality, this is where he could end up. Nevertheless, she thinks he's making a good step.
Britten returns home with the penguin, where Rex finds him frantically looking everywhere for the ring. At one point, the penguin motions to Rex, causing Britten to ask him if he took the ring. Rex admits he didn't think it was important and gave it as a gift to his girlfriend. Britten is doubly shocked by his son for stealing something and having a girlfriend without telling him. Britten asks Rex to bring down some walls and rely on him the way he relied on his mom. Rex starts by inviting his dad to meet Emma that night.
After meeting Emma and re-acquiring the ring, Britten goes to sleep and wakes up as Dr. Lee checks his pupils in the mental hospital. Lee explains that Gabe dosed Britten with ketamine, which will take a few hours to wear off. When the lights flick off, Britten knows SWAT is about to storm the building to shoot Gabe. He begs to make a phone call so he can inform the team about the dead man's switch. No one gets answers if everyone dies! Finally, Gabe permits Britten to call Vega, who rushes to call off SWAT. Britten secretly gives additional instructions to Vega to investigate any information about Dr. Wild and a trip Gabe took with is sister in 2007.
During a quiet moment, Gabe tells Britten that while seeing Christy in his mind brings some comfort, he doesn't want to imagine her anymore. He wants her to be real. Britten can't help but catch the connection to his own situation. Noticing a penguin in sitting next to Dr. Lee, Britten is frustrated that his hallucinations haven't ceased. Vega calls Britten with no leads. The only "wild" is the Wild Rose Cemetery where Gabe's sister was buried, and Gabe couldn't have been on a trip in 2007 due to his fear of travel. Britten consults with Lee, who's amazed that Gabe is inserting details surrounding his sister's death into his narrative - on some level he remembers she's dead. Guiding Gabe to the truth in this narrow window Dr. Lee theorizes Gabe is finally realizing on some level he buried his sister, thus the "underground facility" and "wild" connection. He wants Britten to help Gabe face the truth, since it may be the best chance they all have to survive.
Running through the fatal car crash in his mind, Britten is still searching for something to say when he realizes Gabe's full name is Gabriel Wyath III. Drawing on his own reality, Britten fabricates Christy's story, claiming she escaped the secret location. It appears Britten would rather Gabe believe in a world where his sister was alive than actual reality. Britten claims Christy left a message saying she's okay; she's free, and some day, some way, they will see each other again. It ends with the line, "I love you, Trip." Gabe tears up knowing this must be a real message due to the inclusion of Christy's nickname for him. Relieved that Britten has finally presented him with the truth, Gabe turns himself in.
Back in therapy, Britten explains to Dr. Lee that Trip is a popular nickname for thirds, and he acted on a hunch after noticing the full name Gabriel Wyath III. Meanwhile, Dr. Evans wonders why, when given the chance to help someone with the truth, Britten chose to let the person live in denial. Unable to see how the truth would benefit Gabe, Britten asks, "What's so great about reality?" Evans acknowledges Britten himself has the keys to see what's real and what's not, yet he still prefers to live in two places. She notes in his "dream world," Britten turned himself into a hero, winning the affection of the wife he feared losing and even impressed the therapist who had doubts about him. When Britten points out that Gabe didn't need a revelation for his story to turn out okay, Evans points out that he's comparing himself to a dangerous schizophrenic.
Britten gets more adept at juggling both worlds, preventing the slipups that were occurring earlier. Drink details are remembered and case items aren't confused. Britten is regaining confidence in his ability to manage this strange phenomena until Dr. Lee mentions the police kept him outside the building during the entire hostage crisis. Could Britten have imagined Dr. Lee was there, just like the penguin? Britten's mind is racing as he starts to re-question everything that happened inside the hospital as Lee, who seems to be finally warming up to Britten, unintentionally offers him the worst possible advice given everything that just happened: "Maybe you should get some sleep."