With acting boss Jackie Aprile dying of cancer, Tony prepares for a power struggle with Uncle Junior. Christopher and his associate Brendan make trouble for themselves when they jack a truck full of DVD players. Tony's mother Livia finally agrees to live in a retirement community. Big Pussy and Paulie Walnuts are sent to find a stolen car.
Uncle Junior's associate Mikey Palmice stirs things up by making Junior think Tony wants to be next in line for boss. Meanwhile, Tony, Paulie and Silvio deal with Hasidic family problems.
Jackie Aprile's health worsens, forcing Tony to make a tough decision. Meanwhile, Anthony Jr. learns the true nature of his father's job in 'waste management.' Also, Tony hires sleazy police lieutenant Vin Makazian to investigate Dr. Melfi's background.
An accidental emission has Carrie certain that she and Mr. Big will never share a bed again. The last three months have Miranda convinced she will never share a bed with any man again. A foray into tantric celibacy leaves Samantha craving old-fashioned sex, and Charlotte's boyfriend would rather be mentally balanced than sexually active.
What starts out as a great trip quickly turns into a nightmare as Doug and Arthur are forced to switch planes, which puts them in Pittsburgh instead of St. Louis. And if the travel snafu isn't bad enough, Doug discovers that Arthur is deathly afraid of flying and is forced to talk him off the ledge several times throughout the flight.