Since we haven't seen a new episode of this show since January, Jeff Zucker provides a recap for us. Lucky for you, I know of this really awesome site that provides recaps of every episode of the current season, which you can read at your leisure.
Anyway, when last we saw Earl, he was lying unconscious in the middle of the road, after tossing away his karma list and being hit by a car. Said car was driving by Billie (Alyssa Milano), the love of Earl's life, who was then also promptly hit by a car and knocked unconscious. So Earl and Billie: both unconscious. Got it?
Earl VOs that ever since childhood, when his parents fought a lot, he would retreat into television when things got tough. So now that Earl's body is in a huge amount of pain, Earl's mind creates a '60s-style television show where Earl is an advertising executive and Billie is his stay-at-home wife, complete with flowered dress and apron. And corny sitcom-y jokes. I do like the attention to detail in the set dressing though. Billie makes an offhanded comment to Willie the Two-Eyed Mailman, showing that in Earl's dream world, everything is better, since in real life the dude's name is Willie the One-Eyed Mailman.
Back in the real world, the paramedics have arrived, along with Camden County's bike cop and Mike O'Malley, the ex-cop. Mike was the one driving the car that hit Billie, although he keeps that to himself at first. Randy rushes to Earl's side and begs the paramedics to help his brother, but they are busy trying to help Billie. Randy flashes back to the last time Earl's life was in danger -- Earl shot an arrow up into the air, and when he bent over to get a second arrow, the first one came down and stuck Earl in the back. And Randy ran away instead of helping him. So this time, Randy vows to be a man of action -- he loads Earl in the back of the ambulance, hops in front, and takes off. The cop calls it in, but since he's on a bike, he can't really give chase.
Randy rushes down the highway, but he keeps turning around to check on Earl, and swerves all over the road, which causes the unconscious Earl to slide off the gurney. Randy turns on "the radio" (actually the communications radio) and the dispatcher asks him to return the ambulance at once. Randy: "How'd that DJ know I stole an am-bu-lance!"