Christopher has an out-of-body experience that spooks Paulie to no end. Carmela urges Tony to have a vasectomy. Visiting her own psychiatrist, Melfi reveals the 'unholy alliance' she's made with Tony...as well as her growing dependence on pills and alcohol.

Tony gives Carmela a sapphire ring for her birthday...and Christopher gives Adriana her very own music club. Anthony Jr. gets busted for vandalizing the school swimming pool, but finds the punishment doesn't fit the crime. Tony test-drives a new Mercedes--and the Mercedes saleswoman, Gloria.

Silvio and Ralph must take care of a planned protest of the Columbus Day parade by a Native American group. At an Italian pride ladies' lunch, Carmela is embarrassed by anti-Mafia remarks. Meanwhile, Ralph deals with new relationship troubles, and Bobby receives some tough news.

After hiring an attractive French hostess, Elodi, Artie agrees to loan her brother some money, with interest. Meanwhile, Christopher gets some new responsibilities; Carmela fixes Furio up with an oral hygienist; Anthony Jr. becomes the 'dough boy' of a new rich girlfriend; and Tony receives some unsettling news about an old acquaintance.

Friends and family gather at the Sopranos' for a not-so-surprise 75th birthday party for Carmela's father, Hugh. Meanwhile, Johnny Sack shows off his new wheels, Phil Leotardo pulls into Pussy's old place for some auto repairs, and Tony B. considers accepting a familiar job on the side.