Sawyer and his gang have stopped at a watering hole. Sawyer notices Miles looking at Claire, and tells him not to even think about her. Sawyer tells Miles that he has a twenty-foot restraining order keeping him away from Claire. Miles asks if Sawyer is her big brother. No, her big brother is currently being prepped for surgery. Sawyer threatens to put a boot in Miles's face unless he agrees to back off.
Back at the beach, Rose and Bernard are scrubbing down a piece of airplane wing (which will serve as operating table) with some Dharma Brand Medical-Grade Antiseptic. Bernard tells Rose that he's certain Jack will be fine, as an appendectomy is a simple surgery. Rose's real concern is why Jack got sick in the first place; the island is supposed to be a place that cures your cancer or enables you to walk again, not a place that allows your useless organs to become infected.
Okay, all you shaving fetishists -- this is the scene you've been waiting for. Juliet is in Jack's shelter, shaving his stomach in anticipation of the surgery. Juliet reassures him that when she was a resident, she did a lot of appendectomies, and Jack points out that the actual incision will be two inches lower than the place she's shaving. She knows, but decided he could use a little manscaping. Jack tells her that he wants to be awake during the surgery so he can talk her through it. She asks him how he's planning on seeing his own stomach, and he tells her that he wants Kate to hold up a mirror. 'Cause nothing says you love a person like forcing them to watch your surgery.
At the hospital, Jack is walking a patient out, telling her not to eat any solid food before her surgery in the morning. As she walks away, he notices a man stand up and follow her. We only see him in partial profile from the rear, but it looks an awful lot like Jack's father, Christian. And then a lady doctor with an aggressively fashion-forward haircut asks him to look at an X-ray. A receptionist interrupts to tell him that a doctor is calling from Santa Rosa hospital about a friend of his.
Jack and another doctor walk down a very institutional-looking corridor. The other doc is telling Jack that "he" has refused to take his medication and has stopped sleeping. And therapy's not too helpful, since the patient refuses to acknowledge his doctor's existence. The doctor unlocks the door and lets Jack into the patient's room. It's Hurley. You were expecting someone else? Hurley's just sitting there, staring into space. Is he about to have a flashback of his own? No, he's just depressed. He tells Jack he's not taking his meds because he's already dead. As are Jack and the other members of the Oceanic 6. Jack thinks that's a silly theory, but Hurley asks him what he did that day. It turns out that the things he did (being with Kate, see Aaron, not be a drunk) sound an awful lot like the kind of perfect life you might get in heaven. Does that mean Hurley thinks he's in hell? Jack is offended at the idea that he could only be happy if he were dead. No, that's me -- I can only be happy if Jack is dead. Hurley tells Jack that Charlie comes to visit him, and likes to sit with him on the bench on the front lawn of the hospital. Jack tries to humor Hurley and asks what he talks about with Charlie. It turns out that yesterday, Charlie told him that Jack would come for a visit. And also to pass on a message to Jack: "You're not supposed to raise him, Jack." Jack is clearly thinking that this is a reference to Aaron, and he's kind of angry. And then he gets scared when Hurley tells him that Charlie said that Jack should expect a visitor of his own. Commercials.