As the episode unfolds, it is revealed that her adult children have been enabling her condition, feeding her constantly to keep her immobile and dependent, effectively using her as a human anchor for their own psychological issues.

The doctors must perform a gruesome "couch-ectomy," surgically separating her flesh from the furniture so she can be transported to the hospital.

The tension in Sean and Julia’s marriage continues to simmer as they struggle with the arrival of a new baby and the general chaos of their lives.

In this episode, Christian Troy and Sean McNamara are called to a local home by paramedics to perform an emergency "on-site" surgery. The patient is , an morbidly obese woman who has not left her sofa in three years.

The story centers on the horrifying discovery that Momma Boone has literally . Because she hasn't moved in years, her skin has grown into the fabric and stuffing of the upholstery, and she is suffering from severe, life-threatening infections.