Sean experiences the ugly side of Hollywood in the form of a television critic. Matt experiences a special bond with one of Christian's patients. The cause of Julia's ailing health is discovered.
Sean is lambasted in a review by TV critic August Walden. Urged on by Kate’s reminiscence of her bad reviews and Christian’s gloating, Sean heads to the man’s favorite coffee shop to rip into him. In a corner, pounding away on a laptop, he finds the hideously ugly Walden. Instead of the diatribe he planned, Sean tells him that he is so mean-spirited because of his anger at his own form. The next day, Walden arrives at McNamara/Troy for a makeover, fueled not only by Sean’s comments, but also by his crush on one of the barristas.
Meanwhile, Julia’s looks are sliding even further downhill, and her hair has been falling out. When Olivia returns, she confesses to her affair with Christian, declaring it over. She tells Olivia of the mysterious illness that Christian doesn’t believe. Skeptical of Western medicine, Olivia sends a sample of her hair to a lab for testing. The results indicate mercury poisoning, and Julia confronts Eden after sending a piece of her fruitcake to the same lab.
The surgeries on Rachael have not produced significant results, and she decides she does not want any more procedures. She has also decided that her relationship with Matt is going nowhere, and she is moving back to Tel Aviv.
A young girl named Emme has made her way from a small town in Georgia to seek pro bono surgery from Christian to correct a facial birth defect. Her mother has looked upon it as her punishment for sexual immorality following a one night stand. After the surgery, Christian nudges her Matt’s way. Sensing that Sean and Christian are using her to drive him away from Rachel, Matt storms off. But after being dumped by Rachel, he ends up in bed with the sweet, good-hearted Emme.
But then, just after they had sex Emme is Christian’s daughter and therefore, Matt’s sister. The two of them research this type of relationship online, but Emme freaks out when considering that if they conceive any children, they might develop birth defects. Sure, it’s a long way off, but her personal experience brings it to the forefront.
A cruel twist ending has Walden returning to his coffee shop, reborn and ready to approach the girl he wants. But before he can say a word, another barrista cuts him off, telling him that his dreams of being an actor were cut short by a Walden review. Outraged, he throws a pot of hot coffee in Walden’s face.
Eden tells Julia that she will turn herself in and make a full confession. But as quickly as she leaves the room, she returns with the pistol that Julia had purchased for protection. Deciding that the Mercury is taking too long, she aims the gun and steps out of frame. We hear a shot fired, and Julia screams as the episode ends.