A sleek limousine pulls up outside the hospital. Out comes a tight-lipped woman somewhere in her 60s, dressed head to toe in pearls, not a hair out of place. When Rizzo sees her enter the hospital, he's terrified. He tries anything to deter her path: knocking over plants, coffee cups, mail. But she cannot be stopped. With a cat in her bag, the woman walks right up to Juanita and demands to see Dr. Coleman. When Juanita says she needs to wait her turn, the woman offers to choke her. Rizzo is in George's office, trying to warn him who's waiting outside. To his horror, George realizes it's Virginia Coleman - his mother.
Right off the bat, it's clear that Virginia has... zero filter. "Look at this place!" she tells George. "It's almost like a real hospital. How long do you have to do this before they let you work on humans?" George can barely stand the sight of her, and in less than 15 seconds, his mother's already inquiring as to whether or not George is seeing anybody. Just his therapist. George is checking on Virginia's cat named Cat. Apparently Virginia can no longer see her regular vet because he hit on her, and who wants to date someone who spends half his life with his finger up a dog's keester?
Dorothy welcomes Jill to the hospital, assuring her it's fun, and that she'll get her own office when one becomes available. They walk into the break room, where the hospital staff is playing a game of darts. The winner - Rizzo - gets to pick the restaurant for Free Lunch Friday. After spying Mr. Wesley, who's on the board of directors, Dorothy chases after him. Yamamoto is holed up in the lab looking like he hasn't slept in days. He tells Doug he's researching mysterious pigeon deaths: he even has a map dotted with thousands of pushpins representing the birds. He asks Doug to join in his quest, but Doug refuses and advises Yams to leave the pigeon shenanigans alone. Watching him flutter about, Juanita tells Doug that she overheard earlier that Yamamoto's wife kicked him out.
Mr. Wesley comes down hard on Dorothy. In her short tenure, productivity levels have gone way down - and the break room resembles a "Charles E. Cheese"! Wesley wishes Dorothy ran the hospital more like her grandmother did, with an iron fist and acid tongue. When Dorothy hears George's mother visited the hospital, she's shocked. George told her his mother was dead! George claims he was just trying to protect Dorothy. George and Angela face off with memories from their childhood, with a game of Whose Mom Is Worse? George's mom took him out of a school he loved because the principal had "gypsy eyes" while Angela's mother slept with her principal and they had to move. When Juanita presents the blood work from Virginia's cat, George looks defeated. It's not good news.
George appears at his mother's doorstep on the Upper East Side and enters her grandiose apartment. She immediately asks him to fix her a drink, straight vodka in a teacup. George has come to deliver bad news: Cat has a malignant brain tumor and the prognosis doesn't look good. Now who will keep Virginia company during her baths? George has a disturbing flashback to his childhood, sitting beside his mother while she's taking a bath, reading her "Tropic of Cancer." If Cat passes away, Virginia needs George more than ever. Determined to find a way to save Cat, George leaves, just missing Virginia's neighbor, Olivia, who inquires about her Cat. She thanks Virginia for taking Olivia's dying, precious Cat to George for a second opinion. Looks like Virginia's playing tricks just to get closer to her son!
George gathers the hospital staff for an inspirational speech about saving Cat because if they don't save him, George will be sucked in to fill the lonely void that is his mother's pathetic life. Apparently there is no worse fate. Meanwhile, Dorothy is struggling with the prospect of filling the shoes of her grandmother Eleanor Crane, who ran the hospital up until her death about a year ago. Dorothy knows the board thinks she doesn't measure up; she refuses to fail at this like she did when she dropped out of Columbia Law School and couldn't make her start-up bakery work. Jill inspires her to kick ass instead of nurture ass, and Dorothy agrees. Time to change up her game plan.
Doug finds Yamamoto in a cab, staking out the PPK Killer aka the Pigeon Poison Killer. Yams believes an elderly man feeding the pigeons is the perpetrator. At the hospital, the staff walks into their break room only to find it's been stripped of all it's fun. No espresso machine, no foosball table. Dorothy's trying to increase productivity. The nurses, angry that their break room has been taken away, declare themselves on "slow-down" which means they do everything in slow motion.
In a frenzy, Yamamoto attacks the elderly man, but it turns out he's just feeding the pigeons stale bread. When Doug intervenes, Yamamoto breaks down. "These pigeons were trying to be the best husbands they could, but they've been ignored, berated and mocked sexually!" Clearly, there's something deeper underlying Yams' pigeon-mania. At the hospital, the nurses are still on quite an impressive "slow-down," much to Dorothy's frustration. Virginia's back at the hospital, already planning a cruise to Copenhagen with George. Lucky for George, Cat has pulled through his surgery! Virginia shocks her son, saying he's an excellent vet; she's very proud of him.
When Angela notices how bummed George looks, he reveals Cat passed away on the table before George could even operate; he was simply too sick. George got a different tabby at the local shelter and passed her off as Cat and now feels he must tell Virginia the truth or forever live with guilt. George goes to his mother's apartment and tells her the truth. She's hurt that he would go through such lengths to avoid spending time with her, but just at that moment, George realizes there are no scratches on the couch or even the wafting scents of a litter box! Turns out both of the Colemans are liars. Gorge rushes out of the apartment in a huff. Women like his mother will never change!
At the hospital, Yamamoto dejectedly cleans up his pigeon research. There was never any poison, just a simple virus that was striking down the birds. Talking in metaphor, Doug reminds Yams that if any pigeon ever needs a friend, or even a spare bedroom, he's always there. Yamamoto decides to temporarily move in with Doug. George is still upset about his mother's web of lies, but Angela reminds him that no matter what kind of crazy things mothers do, they're still family. Angela sees her mother every week.
Looking for Eleanor's bourbon, George finds Dorothy sitting in her office. Unable to understand why Dorothy would ever aim to run the hospital like her grandmother, George reads her some memos from the board from Eleanor's time. Turns out they actually hated her! George gently advises Dorothy to run the hospital as she sees fit. It's not long before the break room fun is back. On her sixth shot of espresso, Angela is particularly elated, and Jill cons Dorothy into putting her in Eleanor's office. George buys his mother a turtle (that she names Turtle) and promises to visit her once every three weeks, and even on her birthday and Christmas. Things are looking up for these two crazy Colemans.