Buffy is walking down the street, with a list of recently rented houses, many of which are crossed off. She's obviously looking for the nerds. Little does she know, she's actually approaching their place. In the basement where they are hiding, Warren shoots Jonathan with a water gun as punishment for sleeping while on surveillance. Jonathan is still very upset about Katrina, and is very stressed. They all begin to fight, until they see Buffy on their surveillance monitors. Andrew uses a large wooden musical instrument to summon a demon. Buffy fights the demon, and it pricks her with a stinger that pops out of it's arm. Instantly, Buffy is no longer on the street, but in a mental hospital. The demon is now two medical workers, and the stinger is an injection. Willow is at college, practicing asking Tara out on a date. She sees Tara, and starts towards her, but a stop short when a young woman walks up to Tara and kisses her on the cheek. Willow watches the two of them talk for a moment, then turns and walks away. Tara notices her, but Willow is too far away for her to catch up. Buffy is at work, when her boss calls out to her. Suddenly, Buffy is back in the hospital reality, being offered her drugs. Just as suddenly, she's back at the Doublemeat Palace, and discovers she burned a batch of fries. Back home, Buffy finds Willow checking her laptop for Xander e-mails. Willow tells her what happened when she went to see Tara, and Buffy sympathizes. The topic switches to the whereabouts of Xander and Anya, but they are interrupted when Xander shows up. They hug him, and he asks about Anya. She took some stuff, and the Magic Box is closed. They tell him that they don't know. He makes an impassioned speech about how badly he messed up and how much he misses her. Spike is heading to his crypt with groceries and comes across Buffy patrolling. He asks about the wedding, and she fills him in. As they sit around and talk, Xander and Willow pop up. Xander and Spike are immediately in each other's faces, being amazingly cruel. Willow tries to prevent a fight, but Xander punches Spike. Meanwhile, Buffy begins to have a bad physical reaction to something. In the hospital reality, a doctor is talking to Buffy. Back in Sunnydale, Willow and Xander notice Buffy and go to her. Two seconds later, she's back in the hospital. The doctor tells her to see who's there, and as Buffy looks up, she sees her mother and father. In the hospital, Buffy's parents are surprised that she is so lucid. The doctor suggests that them talking to her is helping. They try some more, but she covers her ears. In Sunnydale, Xander and Willow escort Buffy home, ignoring Spike's offer of his crypt and his advice. Back home the next morning, Buffy tells Willow, Xander, and Dawn about the demon stinging her, and the hallucinations. Dawn reacts very strongly to Buffy's mention of their parents. Willow starts handing out research assignments when Buffy suddenly retreats back into the hospital reality. In the doctor's office, Buffy listens to the doctor talk to her parents about her condition and any hope that she may recover. He says that she created a fantasy world called Sunnydale, where she and most of her friends have super powers and fight various amazing battles. Her main delusion is the slaying, and everything else was made to support that. Buffy mentions Dawn, and her father asks if that's "the sister." The doctor explains how Buffy added Dawn, changing the whole past four years of her fantasy world to accommodate her. He says that her fantasy is breaking down, asking Buffy why her past enemies have all been monsters and gods, but this one is three human men. Jonathan looks up the stairs to the basement as Warren and Andrew come down loaded with packages. He asks where they were, and they say getting stuff and observing Buffy. They are pleased to report she is wigging out, but Jonathan is more interested in the packages. Warren says it's stuff they need, and they'll fill Jonathan in when he stops freaking out. Jonathan starts to leave, saying he needs "stuff" too, but Warren stops him. Warren tries to explain that they're a team, and it's too dangerous for him to go. But Jonathan doesn't seem convinced. Buffy is looking at a photo of herself as a child with her parents when Willow comes in, having found the demon online. She says the antidote is in its stinger. Buffy talks about how real the hospital reality is to her, and confesses to Willow a long kept secret. When she first saw vampires, she freaked and told her parents. Convinced there was something wrong with her, they had her institutionalized for a few weeks. She stopped talking about the vampires, and got let out. Her parents eventually forgot. Buffy tearfully asks Willow what if she never left. Xander and Spike are hunting for the demon. They argue quite a bit, but are interrupted by finding it. It's a very strong fighter, but Xander eventually gets in a few good hits with tranquilizer darts, and they capture it. Dawn brings Buffy tea, and tries to take care of her sister. But Buffy brings up the stealing, and also accuses Dawn of letting Willow do her chores. In the hospital reality, Buffy's parents plead with her to admit she has no sister. Buffy does, but equates it to Dawn being the key. Back in Sunnydale, Dawn is upset that she's not in the other reality. She tells Buffy that she's not wanted, that the hospital is Buffy's dream life and Dawn's not in it. Before Buffy can argue that, Dawn storms off to do her chores. In the basement, Willow watches Xander and Spike attempt to old the demon. With great difficulties, they finally do, and she breaks off it's stinger. She sends Xander out for supplies, assuring him it's not magical, and Spike stays behind to watch the chained up demon. Willow brings Buffy a mug of the antidote, andinstructs her to drink it once it cools. Spike pops in, an Willow tells him to make sure Buffy drinks it all. She leaves, and Buffy tells Spike to go too. Spike tells her that he figured it out. She's not dark like him; she's in love with misery. He leaves, but gives her an ultimatum. Tell her friends about them, or he will. Looking very distraught, Buffy dumps the antidote into the trash. In the hospital, Buffy tells the doctor and her parents that she wants to get better, she wants to go home. She asks the doctor what she has to do. He tells her she needs to separate herself from the things that hold her there. She realizes he means her friends. He tells her to do whatever she has to in order to sever her connection to them. In Sunnydale, Buffy talks to Willow. She says she took the antidote, and Willow offers her some breakfast. A little bit later, Xander comes in, and finds Buffy doing dishes in the kitchen. He also assumes she took the antidote, but is proven wrong when she beans him with a pan. They fight, but before too long, she knocks him into semi-consciousness. Buffy drags Xander into the basement. He sees Willow laying on the ground, bound and gagged with duct tape. Before he can ask her what happened, he slips into unconsciousness. Buffy looks over at the demon, still chained up. Buffy leaves the basement, locking the door behind her. She calls for Dawn, and heads up to her little sister's room, finding Dawn packing an overnight bag. She says she's going to stay over with Janice, where people want her around. Buffy tells her she's not leaving, and attempts to grab her sister. Dawn runs, and pleads with Buffy to talk to her, professing her love for her sister. Buffy ignores Dawn, and brings her down, commenting on how ridiculous this all is. Dawn is thrown on the ground in the basement, tied up. Buffy gags her, and heads over to the demon. Xander wakes up, his hands tied to a wooden post, just in time to see Buffy release the demon. He stands, and yells to her for help, trying to fend the demon off with his legs. Xander's rope breaks, and the demon throws him. Everything flips between Sunnydale and the hospital. Joyce is encouraging Buffy to keep fighting. But in Sunnydale, Tara shows up, and eventually sees what's going on in the basement. She uses magic to untie Willow and Dawn and to knock some shelves into the demon, But Buffy grabs her ankle then, and Tara falls down the stairs. Willow runs to her side. The demon is winning the fight by a landslide, hurting everyone s Buffy watches. In the hospital, Buffy is reacting very badly to what's happening to her friends. Joyce tells her in a passionate speech that she knows Buffy has a strong heart, and can fight this. Buffy thanks her mother, agrees that she can, and says goodbye. In Sunnydale, Buffy jumps into the action and fights the demon, soon killing it by punching a hole in its chest. Xander assures Buffy that everyone is okay, and Buffy asks Willow for the antidote. Willow agrees to make more. In the hospital reality, the doctor shines a light into Buffy's eyes, and is forced to tell her parents that she in unresponsive. Joyce weeps as Hanks holds her.