At P3, Piper slices some strange-looking fruit. She is continuously coughing and her voice is raspy. Phoebe walks in and announces she's just enrolled in college. Piper identifies the fruit as kiwano; the bartender helped smuggle it in from South America. Phoebe tells her to go home, as she is clearly not well and needs to rest, but Piper says she's fine and continues working.
At Buckland's, Jack and Prue examine a putative Monet. Prue notes the similarity to Monet's style, but thinks the brushstrokes around a train smokestack look suspicious and doubts that it is authentic. Jack tries to turn the conversation to their relationship.
Piper is worried that the crowd may be over capacity, but Phoebe insists that Piper go home. She says she's fine, but then she starts feeling lightheaded and collapses. She awakens in the hospital and finds Prue, who insists she take some time off after she gets out of the hospital. Phoebe goes to the hospital, and finds out a new doctor, Dr. Williamson, is attending Piper. Phoebe sits in the waiting room where she finds a young boy, Nathan, who has a ninja doll. She suggests that the doll is a wizard and can freeze, move and kickbox the "bad guys" in his body. She returns the doll as Dr. Williamson meets her, accompanied by four or five interns. He's an infectious disease specialist, something that worries Phoebe.
In Piper's room, Dr. Williamson tells Piper that she has Oroya fever, a disease common in South America and the Caribbean but rarely seen in the United States. Piper has not been out of the country lately, or even out of San Francisco, but Phoebe remembers the kiwano. Dr. Williamson says that a sand fly that carries the disease could have gotten in the crate. Piper notes a bite on her shoulder. The doctor orders an antibiotic. Phoebe wants to call Leo, but Piper won't hear of it; he isn't their Whitelighter anymore, and she's committed to Dan.
Prue goes back to Buckland's and Jack notes that there were indeed some suspicious thread markings on the painting. He hasn't told Mr. Cauldwell yet. Jack tries to encourage her to take the day off, as she is exhausted, and tries to reassure her about Piper. A nurse calls Prue's cell phone. Phoebe goes home and Dan tries to comfort her. Prue calls the manor and tells Phoebe to get to the hospital. Dr. Williamson says that Piper's condition has worsened and there is nothing more the doctors can do for her.
Prue desperately searches through the Book of Shadows; she doesn't want to let Piper die. Phoebe thinks this borders on personal gain, but wants to try Leo. Both call his name. He orbs in, startling them. He tells the sisters that "they" won't let him heal Piper since the illness didn't come from fighting evil. He has to leave, and orbs out. Prue and Phoebe try the Book again, and find an awakening spell.
Prue and Phoebe go to the hospital, where Dan is waiting in Piper's room. While talking to a nurse, Prue crooks her finger and swipes a vial of Piper's blood. Phoebe meets Nathan, who feels better now. Phoebe wants to borrow the ninja doll, and Nathan says she can keep it. Phoebe sends Dan after some sodas, and the three sisters are now alone. Prue and Phoebe cast the spell. Dr. Williamson tries to enter, but Prue holds the door closed. Piper is now healed, to the astonishment of Dr. Williamson. Phoebe tosses the ninja doll in an infectious waste bin -- where it comes to life. The ninja doll jams its katana into a nurse's leg and cuts its way out of the bin. Hours later at P3, Piper has more energy than ever. Dan is exhausted and heads for home. Piper suspects that Phoebe and Prue cast a spell and that this might constitute personal gain. Prue goes off to further examine the Monet. Piper cleans up the bar, a dynamo at 2 AM, and Phoebe realizes that this may be the backfire. At the hospital, the nurse stabbed by the doll has Oroya fever, and so do two others. Dr. Seiger from the CDC arrives. Dr. Williamson tells Dr. Seiger that he thinks there's been an Oroya outbreak--and it's somehow tied to the first patient, Piper.
Prue tells Jack that the painting isn't a real Monet; one of his students painted it. Jack wants to pass it off as a Monet, but Prue is unwilling. Prue insinuates that their relationship is "almost perfect," like the Monet.
A squad from the CDC descends on P3. Dr. Seiger takes Piper and Phoebe into custody, and closes P3. Dan is watching a press conference conducted by the two doctors, and rushes to the hospital.
Piper and Phoebe are in an isolation ward, and aren't getting any answers. Prue walks in and says the CDC was waiting for her at the manor. She overhears that other patients are infected. Neither of the sisters got any sleep--and Prue thinks that might not be the only consequence of their spell. Dr. Williamson walks in. Although the disease isn't airborne, six people are now infected, and Dr. Williamson intends to keep the sisters in quarantine until he figures out how Piper survived.
The sisters draw blanks on how to keep other people from dying. Piper, at last, suggests reversing the spell. She is now willing to call Leo, but Prue tells her that she's already talked to Leo and he's not allowed to help. Phoebe doesn't know how they can get the spell, but Piper suggests that Prue astral-project to the attic. Prue doesn't think she has enough of a handle on that power yet, but Piper talks her into trying. Prue astral-projects into the attic and finds the reversal spell. Prue and Phoebe say the spell, and as the ninja doll is about to attack Nathan, it becomes a lifeless thing again.
Piper collapses, and the doctors rush in. The doctors cannot revive her. Her spirit rises into a brightly lit realm, where Leo meets her. Leo thinks he might get away with healing her here. He places his hands on her hands. The doctors pronounce Piper dead, but as Leo heals her, she revives. She calls Leo's name -- in Dan's presence.
Prue cleans out her desk at Buckland's. Cauldwell wanted to wanted to pass off the "Monet" as real, and Prue resigned rather than go along. She also breaks up with Jack.
P3 reopens, with no cover charge and free drinks. Piper gets rid of the remaining kiwano. Leo comes in; "they" caught him healing Piper, and for at least a while, he isn't a Whitelighter anymore. He's going to fight for Piper, and seems happy to be a mortal once again.