Alex is reading Charlie his mail when a cranky Melanda appears, complaining that she's never prepared for her period. Does Alex have a tampon? Alex's eyes widen. Come to think of it, she's late too, and it's been six weeks since the accident - could she be pregnant? Freaked out, Alex refuses to talk about it, but Charlie is over the moon with the idea of being a father. This could change everything! Paramedics wheel Chester Mills into the ER. He hit the back of a pickup truck while driving and was impaled by a piece of metal rebar. Not only does he have amnesia, but he's in no pain at all when he should be screaming. After establishing that Chester's airway is open, Zach tells Maggie to get him into X-ray. On the way, she bumps into Joel, who's taken aback when Maggie gives him the cold shoulder.
By the time he hits the OR, Chester has a new name: Mr. Happy. Alex pages Joel, then examines her patient. She tells Joel it's a mystery - they can't figure out why Chester is feeling no pain with his multiple fractured ribs, though they do know they have to operate as soon as possible to get the rebar out of him - it's probably stanching a substantial bleed. Joel decides to interview Chester himself to make sure he hasn't taken any drugs, even though the tox screen came back clean. Joel is just explaining they have to start the surgery to remove the rebar right away, when Chester decides to pull out the rebar himself. Chester immediately passes out as blood pours from his abdomen. Alex jumps in to perform a crash thoracotomy.
Maggie examines Heather Day, who claims her mother pushed her down the stairs, and now she can't move her neck. When she starts rhyming, Maggie suspects there's more to Heather's situation than meets the eye. As soon as Maggie turns her back, Heather wanders off, then begins acting as if she's never seen Maggie. Meanwhile, Chester is awake and feeling perfectly fine with no pain when he should be in agony. Victor has found a card for infamous hypnotist The Great Randall amongst Chester's belongings. Could Chester have been hypnotized? Alex makes a beeline for Gavin, who explains that hypnosis isn't completely understood, but can be incredibly effective when it comes to pain management. Afraid that Chester's hypnotic state is masking his true symptoms, Alex wants Gavin to take a crack at unhypnotizing Chester. After complete failure, Gavin advises Alex to call The Great Randall.
Maggie pages Gavin for a consult on Heather, who's been acting oddly. When Gavin hears about the rhyming, he suspects clang association. Overhearing this, Heather starts yelling and throwing stuff, so Gavin calls for sedatives and tells security to back off. Heather doesn't want to be sedated, but Zach insists that either the doctors will administer the drugs or security will - Heather's a danger to other patients. Alex tells Melanda that although she bought a pregnancy test, she can't bring herself to take it. She knows she wants Charlie's baby, but still... Melanda puts on the pressure to take the test immediately, but Alex is saved by her pager. Meanwhile, The Great Randall arrives at the hospital and pages Alex. When Charlie walks into the lobby, he's amazed to discover that Randall can actually see and hear him!
Randall puts Chester under and takes him out of hypnosis, which makes Chester very, very unhappy. He immediately remembers who he is, and he's immediately in terrible pain - not from his wounds, but from a chronic stomach condition. Chester has been chasing the cause of his malady for five years with no success and no help from doctors, and the constant pain has ruined his life. Why, oh why did they have to end his hypnosis!? Ever stubborn on the side of right, Alex decides she's going to get to the bottom of Chester's condition. After booting Randall out of the room, Alex is surprised to find him waiting in the corridor, hoping to be compensated for his work on Chester. When he comments that she has a great sadness about her, Alex huffs off, clearly not a believer in Randall's skills. Charlie however is a believer, and he wants to know how Randall can see him. Assuming Charlie is dead, Randall asks to be left alone.
Charlie hunts down Randall, begging him to give Alex a message - she needs to know Charlie wants to be a father. Zach finds Alex poring over Chester's medical records. She's desperate to help, but Zach reminds her that she saved Chester's life already - she's done her part, and it's time to move on. Alex proceeds to Chester's room to find that his face has blistered up, another symptom of his painful condition. Yes, he was in the sun during his accident, and he always has this kind of photosensitive reaction. When Jackson remarks that Chester must be a vampire, Alex gets an idea and asks to run more tests. While Chester agrees to the tests, he demands Alex call Randall to put him under hypnosis again.
Heather's mom Donna tells Gavin that she didn't push Heather down the stairs. Ever since she was 15, Heather has been delusional, and it's been downhill ever since. Gavin insists there are better medications than what Heather is taking, but Donna doesn't feel like any drug has ever really helped her daughter. Besides, Heather is an adult, and Donna can't control her; she's never getting better. People like Gavin who dole out false hope just make everything worse. Joel is stunned when Maggie smiles and bites his lip during an illicit make-out session. When he asks if she's mad, she admits he neglected to bring her in on last week's surgery, and he never calls her unless he wants sex. Joel claims he thought this was their deal, and he's been completely honest. Doesn't that count for something? This is all fine with Maggie, but nevertheless, she's decided their "transaction" is done and offers to shake hands on their new friendship.
Charlie and Randall hang out in the hospital snack bar. Randall covers his mouth so it won't look like he's talking to himself and admits the only relief from "spooks" like Charlie is booze. His gift is in fact a curse. People think he's nuts - or they hound him. Randall tells Charlie that he's still half in/half out; he hasn't fully accepted what he's going through. When Alex walks by, Charlie urges Randall to speak with her, so he does, admitting that he started picking up on a spirit named Charlie, who won't shut up. Alex is skeptical until Randall tells her that Charlie's happy to see the birthday necklace he gave her. Charlie is just trying to deliver his message of hope when Randall interrupts to ask Alex for money. Charlie freaks out - Alex will think Randall's a hustler! - and Alex stalks off, feeling like an idiot for believing him.
When Chester claims his morphine isn't working, Alex insists on taking him for a walk, in order to keep his mind off the pain. And why is he alone? Isn't there someone he could call? Chester admits his girlfriend left a long time ago, because she thought his pain was all in his mind. Later, when Jackson reiterates that Chester is a vampire, a light goes off in Alex's head, so she grabs Joel and heads to the lab. Gavin meets with Heather. He wants to change her meds and put her into talk therapy, in hopes of controlling her "hate voices." Heather doesn't think Gavin can help her until he uses a little trick to straighten out her neck - it was just a buildup of dopamine blocking her system. Impressed, Heather agrees to try Gavin's new approach.
Alex suspects Chester has the very difficult to diagnose porphyria, the so-called vampire disease. If he does, his urine should turn red under a black light - which it does. Alex rushes to Chester's bedside to explain her diagnosis. His body is overproducing porphyrin, which is attacking his entire system. She's going to set him up with a hematologist, so they can get Chester situated to avoid future attacks. It will be trial and error for a while. But Chester isn't happy - he was hoping for a cure, not news of a lifelong condition that he's going to have to live with. Alex can name his pain; but who cares if she can't take it away? Afterwards, Alex hooks up with Melanda, ostensibly to take her pregnancy test. She disappears into the bathroom while Charlie and Melanda pace outside, waiting for the results. But Alex walks out without saying a thing...
Alex bumps into Randall in the lobby. He asks for a few minutes of her time, hoping to make amends - he'll serve as a go-between for Alex and Charlie free of charge. When he tells her that Charlie is roaming the halls pining away for her, Alex scolds him for preying on her vulnerabilities, and says a final good-bye. Gavin discharges Heather, who's very excited to tell her mother about her new meds. She'll also be meeting with Gavin every week for talk therapy. If she can stick to her meds and develop some perspective on her auditory hallucinations, she hopes to move out of her mother's house soon.
Alex bumps into Joel, who demands to know what women want. He thought it was honesty, but when he tries to be honest, he comes off like a jerk. Alex tells him he's not a jerk, but to be honest, he's acting chicken. But she can't talk because she's so desperate to get Charlie back, that she had a conversation with The Great Randall. Alex proceeds to Charlie's room to report on the results of her pregnancy test, which were negative. Both she and Charlie are sad, flashing back to an earlier evening when they made dinner together. After a talk about how they both grew up, Charlie proposes making a baby, right then and there. Alex claims she has no time for a baby right now; her career is too important. Charlie's okay with this for the moment, confident that Alex will change her mind and give him six children, all named after him.
Joel shanghaies Maggie in the hallway, presenting her with a cup of coffee as a peace offering and a sign that he wants to become more generous. Maggie wonders if this coded message means he wants to be her boyfriend and refuses to accept his gift until he says the word "boyfriend" aloud. After a couple of tries, Maggie decides Joel's stance is cheesy but likable.