Serenity heads to Ariel — a central world of the Union of Allied Planets — to drop off Inara for her annual Companion physical exam and license renewal. The crew chats in the common room about what they might do while there, but Mal enters to announce that no one is leaving the ship, in order to minimize their visibility in this highly monitored bastion of the Alliance. (Shepherd Book has already left for a visit to a nearby abbey.) Apparently apropos of nothing, River suddenly slashes Jayne deep in the chest with a kitchen carving knife, and Jayne responds by backhanding her. She casually defends her attack with "He looks better in red." (In the director's comment in the DVD set, the writer of the episode said that she was attacking the "Blue Sun" logo on Jayne's shirt, not Jayne himself.)

As Simon stitches Jayne in the infirmary, the mercenary demands that she and the doctor be left on Ariel, suggesting that they might even profit from the reward. Mal quashes any talk of leaving people behind, but after Jayne leaves, Mal tells Simon to keep River confined to quarters, and warns him that he'll have to "revisit the deal" if she isn't kept under control. Simon acknowledges that his sister is getting worse.

While the crew kills time playing horseshoes in the cargo hold, Wash and Jayne bemoan the lack of work they've had in recent stops. Simon approaches them with a proposal: the crew helps him to break into Ariel City's Alliance hospital to use their sophisticated equipment to analyze River's condition, and he'll show them how to raid the tremendous medical stores of the hospital for supplies that won't be missed, but will net Serenity considerable wealth on the black market. Simon's plan has two phases:

   1. Breach the perimeter using an "official" medical shuttle and fake EMT IDs, smuggling in the medically-induced comatose Tams as deceased patients for the hospital morgue, and

   2. Split up, with Jayne guarding while Simon diagnoses River, and Mal and Zoë stuffing the Tams' then-empty "coffins" with the most valuable drugs they can lay their hands on.

Simon claims that leaving won't be a problem, as the hospital security is geared to keeping unauthorized people out, not stopping anyone from departing.

As Simon presents the plan details in voiceover, we see Jayne securing the identification, Kaylee and Wash raiding a local junkyard for parts and equipment (fortunately scoring a battered but intact shuttle), and then Mal, Zoë, and Jayne struggling ineptly to recite prepared medical assessments for their rushed entrance into St. Lucy Hospital's emergency ward. By the time the faux medical technicians have their lines down, Wash and Kaylee display a freshly painted medical shuttle to get them to the door. Although River is terrified of another comatose trip, her brother calms her with the promise of a diagnosis that will help him dispel her nightmares. He tells her, "It's time to go to sleep."

In the shuttle on the way to the hospital, Mal questions Jayne about his participation, concerned about how he might handle himself after getting "a little stabbed the other day". Jayne expresses some grudging admiration for the plan and, more importantly, the upcoming pay, and shrugs off revenge with a joke about giving the comatose Simon a tattoo. Once landed, the "EMTs" rush into Emergency with their "victims", but as they start their prepared spiel, the admitting nurse interrupts them and directs them to the morgue. Mal and Zoë recover quickly from the surprising ease of this hurdle, but Jayne, unable to adapt as quickly, nearly ruins their smooth entry by spouting his now-irrelevant line anyway. Once past the admissions lobby, the two teams head to their respective destinations.

In the morgue, Mal starts the revival process for Simon and River, then departs with Zoë for the supplies room. Contrary to his instructions to watch over them, Jayne wanders off to make a surreptitious call to an Alliance officer, who agrees to pay a previously arranged substantial reward for the fugitives. When Jayne returns to the unconscious Tams, River startles him by rising silently and cheerily announcing, "Copper for a kiss!" Simon's revival is rather more violent, which Jayne finds puzzling until River is heard vomiting off-screen.

Dressed rather appropriately as a doctor, Simon pushes River in a wheelchair toward the diagnostic ward with "EMT" Jayne accompanying them. As they pass a number of patients in a treatment theatre, River insists her brother help a man who is being "killed" by his doctor. When a Code Blue sounds, Simon dashes over to the patient, quickly assesses the problem, revives the man with a defibrillator, and stabilizes him. Simon then turns to the hapless young doctor and berates him for the improper treatment, while River beams at her brother, the gifted surgeon.

Meanwhile, Mal and Zoë, on their way to the supplies room, are intercepted by a doctor who questions Mal. When he starts into a tirade over Mal's apparent insubordination, Zoë steals up behind him and employs her own defibrillator in a rather unorthodox manner. One of the transport coffins gains another use as they take the unconscious medic to the drug storage room and dump him. They rapidly collect everything from Simon's prepared list that they can find.

In the diagnostic ward, Simon puts River under the 3-D neuro-imager. He discovers that her brain has been surgically operated on, multiple times. Her amygdala has been "stripped", supposedly disabling her ability to suppress her emotions. "She feels everything. She can't not." Jayne claims that a change of plans now requires that they leave quickly out the back way. While he and Simon argue, River shrieks and starts to babble in fear. "They come out of the black. They come when you call." She tells Jayne, "Your toes are in the sand." (Jayne makes a typically scatological response.) The three swiftly make their way through the hospital, but are stopped by Federal marshals, who arrest and drag off the Tams. The marshals handcuff Jayne as well, who thinks it's for show, but he quickly learns that the Alliance officer plans to reward him not with cash but with an arrest for aiding and abetting the fugitive siblings, keeping the reward money himself.

Mal and Zoë return with the pharmacological loot, but soon realize that Jayne and the Tams are very late. Kaylee discovers unusual Alliance communications ("on the official 2-6-2") about "ducks", which Zoë recognizes as code, suggesting the second team has been captured. The two war veterans head back into the hospital for another battle to rescue their people. Directed by Kaylee's analysis of the hospital floor plan, and urged on by Wash's announcement of arriving reinforcements, they make their way toward the security substation.

Simon gushes over Jayne's struggle with the Feds, not knowing he was sold out by his shipmate. River launches into an extended Christmas-morning metaphor, with stolen presents, ending by telling Jayne, "Don't look in the closet — it's greedy", which unnerves the secret traitor. As two marshals take the captives to a holding area, a still-handcuffed Jayne brutally attacks them and, with a little help from Simon, manages to kill one and knock the other unconscious. When Simon and Jayne argue which way to go, River tells them, "It doesn't matter. They're here." Back in the substation, the two blue-gloved men (last seen in "The Train Job") arrive to take custody of the Tams. When the Alliance officer reveals that he and his men talked to the fugitives, the "Hands of Blue" take out a mysterious device that appears to emit a high-pitched sound. Within seconds, the Feds are bleeding from every orifice and quickly collapse, apparently dead. The Hands of Blue are unaffected.

Several rooms away, Jayne and the Tams hear screaming, and River begins her ominous litany, "Two by two! Hands of blue! Two by two! Hands of blue!" She runs off in the opposite direction. Not far behind them, the Blue Gloves encounter the two marshals Jayne attacked, and they use the sonic device on the living one. With the sounds of screaming still approaching them, Jayne and Simon follow River's flight until they reach a locked door. As Jayne fruitlessly tries to open it, the lock is blasted from the other side. Mal and Zoë have arrived to help them escape.

Back on Serenity, Inara returns to find everyone but Kaylee absent. The cheery engineer gives her a whimsically shocking summary of events just as the faux medical shuttle returns with all hands aboard. Mal slaps Jayne on the shoulder with an oddly-edged quip about Jayne getting his "big payday", echoing Jayne's earlier implication that his share of the medical supplies bought his "bygones" with the Tams. Simon continues to rave about Jayne's heroism during the escape. Once everyone else has left the cargo area, leaving Mal and Jayne alone to stow equipment, Mal suddenly bashes Jayne unconscious with a wrench.

Jayne awakens to find himself in the outer cargo lock with the door open to the quickly thinning atmosphere as the ship leaves Ariel. Jayne utterly fails to convince Mal of his innocence, and finally confesses that "The money was too good! I got stupid!" Mal lets him know that betraying any of his crew is the same as betraying him, and turns to leave. When Jayne plaintively asks Mal not to tell his shipmates the truth about his betrayal, Mal finally relents and remotely closes the outer door, saying, "The next time you decide to stab me in the back, have the guts to do it to my face." He departs, leaving Jayne stuck in the cargo lock.

Later, Simon approaches River with a syringe. She thinks "it's time to go to sleep again", but he responds, "No, mei-mei. It's time to wake up."

My Review:

Book’s on a retreat, Inara has to have a medical, so the rest of the crew are going stir-crazy with nothing to do.  Luckily Doc Simon is the man with the plan, a simple heist combined with a little free-lance medical scannery.  There are all kinds of complications, Jayne sells out Si and Riv, the Hands of Blue make a return appearance and the good Doc just has to be the big medical marvel and save a man’s life.  Having being double-crossed himself Jayne is forced to rescue himself and the wonder siblings from jail, which he manages quite well, however the HoB go on a murder rampage, killing the cops with a weird blue light thing that’s probably a focused ultra-sonic emitter of some sort, it probably ruptures all sorts of blood vessels inside the head and body, luckily it mostly happens off screen.  The ending is pretty harsh too, with Mal figuring out Jayne’s treachery and he threatens to space Jayne until Jayne realises the depth of his mistake and very quickly learns the error of his ways.  All in all a very shiny episode, which I rate a super seven and a half out of ten.