Previously on Rescue Me: Tommy Gavin got drunk a lot and had a lot of sex with his cousin's widow, Sheila, and hid both activities from his family and co-workers. Chief's wife showed signs of Alzheimer's. Tommy got Sheila pregnant, and the guys from his house beat the crap out of him for screwing a widow. Tommy's cousin, Father Mick, was the one who ratted Tommy out, so Tommy beat the crap out of him. Tommy got distracted during a fire and Franco got injured, which looked bad because Tommy and Franco had had a fight just before that. Janet took the kids and disappeared without a trace. Tommy decided that he wanted to transfer out of his firehouse, and drank some more.
Tommy gets a cup of coffee and whiskey in the break room. He reads a newspaper headline claiming that the FDNY is racist. The alarm sounds, and the crew heads out. On the way into the burning house, Tommy is joking around with his crew about the claims that their department is racist, leaving the viewer wondering if he got a transfer or not, and why everyone is being so nice to him. The crew heads into a smoky room and finds a really fat lady passed out on the floor. Tommy and Garrity struggle to move her out.
Tommy says he's going to grab an axe from the alley, but the ceiling collapses and he's trapped under the rubble. As his crew tries to rescue him, Tommy wheezes and has a montage-type vision. Janet, all in white, tells him that their life could have been perfect, and apologizes for selling the house and taking the kids away. Sheila, also in white, says that the baby is kicking. Franco tells Tommy that it was only a matter of time until Tommy took someone out for good. Janet fantasizes about Tommy's "skinny, little, double-grapefruit Irish ass." Jimmy tells Tommy that it's okay if he's ready to go. Janet and Sheila make sexual suggestions. Tommy's three kids appear on a playground as he remembers Janet suggesting that he take on the full-time parent role. Jimmy urges Tommy to let go. Sheila says that she loves him. Janet tells him not to leave yet. Tommy continues to wheeze, and his heartbeat stops. The screen goes black.
Like you really thought he was dead. Tommy wakes up on the floor of a crummy apartment, an empty whiskey bottle nearby. He slowly pulls himself to his feet and throws the whiskey bottle at the wall. In the kitchen, he submerges his face in a sink full of ice water à la Huey Lewis in the video for "I Want a New Drug," minus the singing. Then he duct-tapes his hands and starts beating the crap out of a sofa cushion he has taped to the wall. Above the cushion is a photo of Janet and his kids, and Janet's face has been blacked out with a marker. So he's still a drunk and he still has rage issues. Got it.