The episode begins with the snippets from last season to remind us why we are tuning in again this time around. Kate Beckett says that they are going to make sure the late Captain Roy Montgomery keeps his good name. Then at Montgomery's funeral she is shot, prompting Richard Castle to finally confess his love for her.
They rush Kate to the hospital and on the way her heart stops. They get her into an operating room where Dr Josh Davidson is the attending physician. After he recognizes who the person in front of him is, he calls for another doctor and tells the rest of the people in the OR that she is his girlfriend.
The scenes go back and forth from the hospital team working on Kate to the reactions of Castle, Esposito, Ryan, Martha, Alexis, Lanie and Kate's father in the hallway. It is done in such a way that it really amps up the tension of the moment.
Josh starts to operate on Kate because she is bleeding and they are going to lose her. After a short while another doctor comes in and convinces Josh to let him take over and he leaves the room.
In the hallway he confronts Castle and accuses him of being the cause of Montgomery's death and the reason that Kate has been injured.