In a desperate attempt to get a brainscan for River so that he can see what was done to her at the Academy, Simon persuades the crew to help smuggle him and River into a highly guarded hospital on the planet of Ariel, promising to make it worth their while by identifying valuable drugs for them to steal. Jayne, who at the start of the episode got his chest slashed by River in a quite infamous AxCrazy moment, is assigned to protect Simon and River during their infiltration while Mal and the others disguise themselves as [=EMT=]s and make off with the goods. The infiltration involves Simon and River having to fake their deaths in order to get in, since they are still very much wanted fugitives. While Simon and River are unconscious, Jayne, who has had issues with Simon and River pretty much from the moment they first came on board Serenity even before he got slashed up by River, makes contact with the Feds in order to turn them in for the reward money. When Jayne returns, River rises like a zombie and says "Copper for a kiss?" which thoroughly spooks out Jayne. Simon's awakening is a little more violent, which is soon evidenced by River vomiting offscreen.

During the infiltration, Simon gets his finest moment when River alerts him to a patient who is being treated incompetently and is about to die, and Simon, who is posing as a doctor that is not on the Most Wanted List, steps in and takes over the operation, saving the man's life and then chewing out the doctor responsible for the incompetent treatment. When the three of them find the room with the holo-imager, both Simon and Jayne learn a bit of what was done to River at the Academy, including having her amygdala stripped bare to remove her ability to block out anything she feels. Simon is horrified at this revelation, and Jayne shows a few signs that maybe turning them in wasn't such a great idea[[note]]or he begins carrying out his original plan at the agreed-upon time[[/note]]. Jayne leads the two away toward a rear entrance, citing a change of plans, and as Jayne and Simon start arguing, River screams and starts babbling. Then the Feds show up.

Along with Simon and River, Agent [=McGinnis=], the Fed in charge of the case, also arrests Jayne for aiding and abetting the two fugitives, intending to keep the reward money for himself instead of giving it to Jayne as he promised. As Jayne learns that [=McGinnis=] has betrayed him in turn, he tries to fight his way out but is subdued when the Feds use stun rifles on him. At the holding facility, Simon shows an incredible amount of balls when he demands to know what will happen to him and River and tells the Feds he is not moving until [=McGinnis=] answers his very simple question, or shoots him. [=McGinnis=] takes the three of them to a holding cell. Meanwhile, Mal and the others twig to the fact that the Feds have arrived when Kaylee and Wash intercept coded communications, and Mal and Zoe set out to rescue the other three members of the crew.

Jayne, who is mad as hell about [=McGinnis=]'s betrayal and feeling a bit of remorse for having betrayed Simon and River, decides to get the two out of there, snapping one guard's neck while still handcuffed and giving Simon the opening to take out the second Fed in the room. But things get even worse when the Blue Hands of the Academy come calling for River. The Feds who Simon talked to, including [=McGinnis=], die a horrific death for having come in contact with River at the hands of a device that makes them all [[TearsOfBlood bleed from the eyes]] and other orifices before dying. As River feels the Blue Hands approach, she starts running, and Simon and Jayne follow. The Blue Hands track the three, killing the Fed that Simon choked out with the same eerie device that killed the other Feds. Jayne quickly hustles Simon and River to a back exit, but can't get the door open with the stolen Fed stun rifle. The three are saved from the Blue Hands when Mal blows open the exit door with a shotgun.

The crew make their escape from Ariel, but things are not done, as Mal quickly twigs to the fact that Jayne was the reason the Feds were even at the hospital and knocks Jayne out with a wrench. Jayne wakes up in the cargo bay airlock of Serenity as the ship is taking off and a confrontation between him and Mal ensues, in which Mal is in full-on PapaWolf mode and vehemently asserts that "you turn on ''any'' of my crew, [[EtTuBrute you turn on]] ''[[EtTuBrute me!]]''" The only thing that saves Jayne from being ThrownOutTheAirlock is when he urges Mal to "make something up" and not tell the rest of the crew what he did. Mal lets Jayne off with a deadly warning: "The next time you decide to stab me in the back, have the guts to do it to my face."

* BadassBookworm: Simon is very much this here
* BavarianFireDrill: Justified in that Simon ''does'' know what he's doing.
* BloodFromEveryOrifice: The sonic weapon used by the Hands of Blue causes very painful death with bleeding from eyes, nose, mouth, ears, and nails, and is easily the main source of NightmareFuel in this particular episode.
* BrickJoke: The part that Wash picks up and immediately flings away is the same as the part Mal used to fix the engine in [[Recap/FireflyE08OutOfGas Out Of Gas]].
* BrotherSisterTeam: Simon and River.
* TheCaper: Obviously.
* DamselInDistress: River. That is the main point of the mission as far as Simon is concerned.
* DangerousPhlebotinumInteraction: In the hospital Simon saves a patient from cardiac arrest, then tears the patient's doctor a new one for causing it. The doctor had made the mistake of giving his patient a painkiller that, when combined with a standard prep drug used for the patient's procedure, reacts to form a vasoconstrictor, which would have killed the patient.
* DeathGlare: Simon to [=McGinnis=].
* DoesNotLikeShoes: River is barefoot while being smuggled into the hospital.
* DramaticIrony: Simon commends Jayne for rescuing them from the Feds, going as far as to say "We wouldn't be standing here if it weren't for him." That was ... not the plan Jayne had in mind, sufficed to say.
* DrillSergeantNasty: Simon. Yes, SIMON. When he was dressing down the incompetent doctor. Of course, he was a more genteel DrillSergeantNasty, but no less scary under the circumstances.
* DrJerk: Mal and Zoe meet one of these while rifling medicine.
* DudleyDoRightStopsToHelp: Simon, mostly at River's insistence.
* EasilyForgiven[=/=]WelcomeBackTraitor: Jayne. He did receive a CoolAndUnusualPunishment, being nearly ThrownOutTheAirlock, but under the circumstances he got off pretty light. With no law to appeal to, many leaders of a smuggling ship would have felt that really throwing Jayne out the airlock was the ''only'' alternative.
* FaceHeelTurn: Jayne's betrayal of River and Simon to the Alliance.
* FakingTheDead: That is how Simon and River get in.
* FoldSpindleMutilation: Mal leaves Jayne in ''Serenity'''s cargo airlock with the door slightly ajar as they're taking off, threatening him with death by spacing for blowing the caper to the feds to get River and Simon arrested.
--> '''Mal:''' The minute we break atmo, you'll be a lot thinner once you get sucked out that hole.
* HeKnowsTooMuch: Anyone who's even had the slightest contact with the Tams, as far as the Hands of Blue are concerned.
* HighAltitudeInterrogation: Jayne in the (open) airlock as the ship goes higher and higher to the atmosphere.
* HospitalParadiso: St. Lucy's. Which provides Mei-Mei the latest medical technology overseen by best medical practitioner on the Most Wanted List. With little paperwork necessary.
* ImpossibleMissionCollapse: Features the instant success variety. Mal, Zoe, and Jayne spend a lot of time practicing medical jargon and a story for the hospital authorities. The nurse clears them to go ahead before they even get started.
* InvisibleMeansUndodgeable: The Hands of Blue's Sonic Device.
* IOweYouMyLife: While River is trying to point out the dying patient, Simon tries to reassure her of the competence of the HospitalParadiso. River interrupts and says, "where you should be...".
* {{Irony}}: Had Jayne been given his award, he probably would have been in the main room when the Hands of Blue arrived and thus gotten zapped like everyone else. By double-crossing Jayne, [=McGinnis=] unintentionally saved Jayne's life!
* ItsPersonal: "You turn on any of my crew, you turn on me..."
* JerkassHasAPoint: Jayne's insistence that River is dangerously insane, that she might come after anyone on the crew next, and that the most sensible course of action would be to dump her and Simon off on Ariel isn't exactly nice. However, given the circumstances, he's also not entirely wrong.
* JumpedAtTheCall: When River points out that an incompetently treated patient is going to die, Simon rushes over to him, saves his life, chews out the doctor and then runs back to River to continue the caper.
* KarmicDeath: The Fed would get his own thanks to the Hands of Blue. Shouldn't have ratted Jayne out...
* KickTheDog: The Alliance rather kicked the dog to death, what with brutally killing their own mooks, betraying Jayne's betrayal, and worst of all the image of how they tore River's amygdala out.
* LethalDiagnosis: Simon points this out to an incompetent doctor.
* LetsGetDangerous: Simon throttles a guard with his knee while still wearing handcuffs.
* LickingTheBlade: Jayne does this in the beginning of the episode... who knew something so unhygienic could look so damn sexy.
* LiveActionEscortMission: Escorting River, in and out.
* {{Lobotomy}}: In this episode Simon finds out that people at the Academy cut up River's brain and removed parts, causing her to feel everything all the time.
* MacGuffinLocation: The room with the 3D imager.
* MagicalDefibrillator: Averted. Simon does not use the defibrillator to shock a patient and bring him back from flatlining. Instead, he injects adrenaline into his heart to get an erratic heartbeat, and then he shocks him to restore the proper cardiac rhythm.
* [[MyDadCanBeatUpYourDad My Big Brother Is a Really Cool Doctor]]: River gives a sweet grin to Jayne after Simon saves a patient as a by-the-way and then stops to give his DrillSergeantNasty. You can just hear her saying [[FacialDialogue "THAT's my big brother."]]
* NeckSnap: When Jayne decides to help get himself and Simon and River out of there, he kills one of the guards this way.
* NervesOfSteel: Simon.
* ObliviousGuiltSlinging: Simon praising Jayne for getting Simon and River away from the Alliance and the Hands of Blue. This is uncomfortable for Jayne, because he's the one who betrayed them and called in the Alliance for reward money in the first place.
* OutOfGenreExperience: [[ImageSource Provides the page image]]. Switches to a MedicalDrama for about 1.25 minutes.
* {{Plunder}}: "How much did we get?" "Enough to keep us flying."
* RewardedAsATraitorDeserves: Jayne's reward for betraying the Tams was to get betrayed and arrested in turn because the chief Fed wanted to keep the reward money for himself.
* RefugeInAudacity: The two most wanted fugitives in the Alliance going in the front door amid wanted posters for them and the possibility of meeting one of Simon's schoolmates. When he rescues the patient and then does his DrillSergeantNasty he is REALLY pushing up the audacity. It works because no one dreams he would do so unless he belonged there.
* ShootOutTheLock: Failed with Jayne and the "''se-niou'' high-tech Alliance crap" stun rifle he commandeered, succeeded with Mal's shotgun.
* SpaceIsAnOcean: ThrownOutTheAirLock is described by Mal as being the space equivalent of keelhauling traitors.
-->'''Mal:''' I don't have a keel to haul you on, so ...
* StiffUpperLip: Simon is keeping rather a stiff calm all through the episode, especially considering the unusual stress and danger to River.
* TheScrounger: Most of the crew does this at the beginning. Notable is Kaylee going through the dump and saying, "Ooh, synchronisers!"
** She and Wash are so good at it they rebuild a MedEvac ship from a bunch of scraps.
* TheStrategist: Simon plans the whole caper; coming near to being a MagnificentBastard in this one.
* ThrownOutTheAirlock: Jayne was lucky to have avoided this fate, as Mal was in full PapaWolf mode and fully intent on spacing him for what he did on Ariel, though he may have been kidding. The very next episode starts with a speech about holding a man over the volcano's edge in order to 'truly meet him'...
* TookALevelInBadass: Simon, throughout the episode.
* VillainWithGoodPublicity: "Federal Marshalls. River and Simon Tam, by the authority of the Union of Allied Planets, you are hereby bound by law."
* WouldHitAGirl: Jayne. Although considering that she had just slashed his chest open, and his own scary-looking combat knife was right there and he conspicuously didn't use it, one could argue that he actually showed surprising restraint.
* WrittenInAbsence: Shepherd Book is meditating at a monastery for the duration of this episode.