Earl is still lying in the middle of the road next to Billie, both of whom are unconscious after being hit by a car. The accident puts Earl in a coma and takes him to an alternate world in the form of a sitcom. Meanwhile, the doctor rejects Earl so Randy, Joy, Darnell and Catalina steal an ambulance to get Earl to the hospital. Karma still seems to be getting the better of Earl when the stretcher is lost and becomes stuck to the front of a truck driven by a crazy lady who has off-screen sex with Earl, claiming not knowing that he is unconscious. Randy and the others get there and 'steal' Earl and take him to the hospital.