Contains spoilers for this episode and earlier episodes.
Junior begins using his new authority in ways that anger the other captains. Mikey attacks a card-game operator under Jimmy Altieri's protection, and Junior orders the killing of Rusty Irish after hearing that a boy died following drug use. Rusty is a valuable earner for Larry Barese, making the decision another source of resentment. At Livia's prompting, Junior also demands money from Hesh, who has never paid him before. Tony brings Johnny Sack into the dispute and negotiates a reduced payment. He then persuades Junior to share Hesh's tribute with the captains and returns his own portion to Hesh.
Tony's medication interferes with his sex life, frustrating both Carmela and Irina. His attraction to Melfi grows through erotic dreams and into a declaration that he loves her. He tries to kiss her during a session, but she maintains their professional boundary. Tony also arranges for her old car to be stolen, repaired and returned, presenting an unwanted intrusion into her life as a favour. Carmela senses that his relationship with the therapist has become emotionally important and breaks down during their anniversary dinner. Tony reassures her that she remains central to his life, and they reconcile. Junior celebrates becoming boss at a banquet, unaware that a waiter is photographing the guests for the FBI. The pictures become part of a board mapping the organisation.