In the opening sequence, a severed male hand is found at the beach. It is unknown whether this is the work of the Ice Truck Killer or not. Whilst investigating the hand, Doakes spots Guerrero's men watching him. After discovering that the hand belongs to Tony Tucci (LaGuerta's Ice Truck Killer suspect) the Lieutenant visits Tucci's mother in an attempt to make amends for branding him a killer on television. She promises to bring him home, dead or alive.
Dexter remembers that this is a beach he came to as a child. During a flashback scene, Harry, his foster father, lectures him on the importance of faking emotions to make other people happy. Back at his apartment, Dexter looks through an old family photo album. It appears that the Ice Truck Killer broke into his apartment to get to know him, not just leave doll parts.
Debra is forced to watch boxes of surveillance tapes by LaGuerta, who continues to make life miserable for her. Kara’s brother continues to taunt Doakes about how he’s going to get himself killed. Doakes lets him know that Ricky wouldn’t come out of cover to give Kara a divorce and that he’s the reason she was killed.
Another body part is found, this time a severed foot at an old football ground where Dexter had played. He tells Doakes that the killer is sending a message that is more important than the ritual, but cannot tell him what, or why. After analysis of the foot, Dexter determines that Tucci is still alive and is systematically having his limbs removed by the Ice Truck Killer. LaGuerta phones Tony's mother to tell her that her son may still be alive and that they will find him.
Angel asks Dexter for his advice on an anniversary gift to give his wife, Nina. He continues to ask for advice from Dexter on various gifts he's gotten, first a diamond-filled stud that Dexter says looks like a butterfly and an "XO" necklace that he says looks like "tic-tac-toe". Angel later buys a diamond heart necklace and tries to find Dexter in the Miami Metro Police Department in order to make sure there's nothing wrong with this gift, but instead finds Debra, who tells him that, "She'll love it." It is revealed, however. that Angel and his wife have been separated for three months due to "something he did." Nina still wants to be alone, despite it being their tenth anniversary. Angel is saddened and proceeds to leave, but Nina gives him the courtesy of seeing their daughter. He apologizes to her, while she is asleep and leaves the diamond necklace next to her, before leaving.
Doakes is kidnapped as soon as he gets home by Carlos Guerrero’s men. As Doakes is about to be killed, the cops rush in to arrest them all. Using him as bait was the plan all along, as Detective McNamara wanted to catch Guerrero dirty-handed. McNamara also told Doakes that they are "even now" (since Doakes had an affair with his sister, who was married, although seeking a divorce).
Dexter follows the clues to an abandoned hospital (another flashback from his past). Whilst searching the hospital, Dexter finds Tucci (who is blindfolded), waiting for his kidnapper to make the final kill. Tucci begs for death, but Dexter cannot kill an innocent man, due to Harry's influence. He makes an anonymous tip to Debra and leaves, resulting in the police arriving and rescuing Tucci. Debra's efforts result in LaGuerta taking her off surveillance duty.
Eric Goldman said: "This was a very strong episode overall, that contained a lot of clever, dark comedy." He also praised the main plot: "The personal touches the killer was doing just for Dexter were a very intriguing aspect of this episode, and gave a natural narrative "in" to the flashbacks we saw of Dexter's childhood this week, as he recalled what was occurring when each photo was taken." Sarah Dobbs of Den of Geek remarked that "there's some nice characterization here." She also praises the sub-plot involving Angel, "It's nice because it's all so cleverly handled."