Lynette balks at the idea of seeing a couples' therapist. Meanwhile, Katherine is seeing her own psychiatrist, Gaby and Susan are determined to find out which of if their kids are in the smartest group at school, and Angie disapproves of Danny's new girlfriend.

Angie’s ex-boyfriend, Patrick, emerges after her trip to New York. Meanwhile it’s game on between Gaby and Susan, as they go to shameless lengths to top each other’s kids; Lynette believes there’s more to Preston’s fiancée than she’s letting on; Bree invites Sam over for a family dinner; and Katherine comes out of the closet.

Susan vows to get the most out of life when she learns that her dialysis isn't working and that, unless she receives a kidney transplant soon, she will die. Meanwhile, jealous of Lee and Bob's adopted daughter's routine for an upcoming school talent show, Gaby pressures Juanita to come up with a number that will outshine everyone; Bree makes it her mission to find a kidney donor for Susan; Lynette puts a plan into action to discourage a clearly non-maternal Renee from adopting a baby; and Beth Young struggles to figure out what to do with her life after Paul kicks her out of the house.