The Keaton family unites in crisis when Steven suffers a serious heart attack.

While Alex and Andy discuss the upcoming Presidential race, Mallory and Jennifer prepare for another legendary shopping expedition. Moments later, Elyse returns home from jogging, but Steven lags behind, explaining that his run was slowed by a burning pain in his side. Steven dismisses the pain, assuming it was due to something he ate, while Alex kids him that the pain was caused by the guilt of being a Democrat.

While Steven fights for his life in surgery, the family fights to remain optimistic about his condition.

When Steven's surgery extends beyond the expected five hours, tension in the waiting room increases. A nervous Alex, however, begins to express acute concern only for himself fearing that he has inherited a weak heart, he searches in vain for his pulse. Lauren soon makes Alex realize that he is fixated on his own health to block the anguish he really feels for his father. While the Keatons wait, they receive hope and encouragement from Mrs. Hobart and Mr. Meyers, whose spouses are also undergoing surgery.

Steven battles the physical and psychological aftershocks of his heart surgery.

As the hours drag on during Steven's quadruple bypass operation, the Keaton crew grows exhausted in the hospital waiting room. Awakened by Skippy's typically goofy entrance, they all snap to attention when Dr. Harrison appears. He assures them that the surgery has gone well, but Steven must still be observed closely for the next few hours.