Arthur's old college buddy, Albie Doyle comes to town because he wants Arthur to perform his hernia operation. Arthur is willing to oblige but when Albie dies of a heart attack following the operation, Arthur falls into a deep depression and decides to quit his practice, leaving Vivian up in arms over what to do.

Maude is depressed with her birthday and has a hard time dealing with turning 51. To make matters worse, Maude and Vivian are set to attend their 30th high school reunion and the only reason Maude decides to go is to see an old buddy of hers, Katie Malloy. However, Maude quickly heads for the bottle when she sees Katie who is paralyzed and wheelchair bound following a stroke.