- Mary falls ills after a fall at the stable, and Dr. Baker is powerless to help her. He recommends a hospital for an operation in a nearby town, but Charles doesn't have the money to pay, neither for the trip nor surgery.
- It's Pa's birthday, and we see him returning from town walking an unfamiliar horse. He's met by Mary, and Pa explains the horse was lent to him to use while one of his own horses has an injured leg. Pa explains he's looking forward to his own horse healing, as the borrowed one is skittish.
Pa is persuaded by Mary to wash up in the creek, knowing that the rest of the family is inside the house, preparing a party for Charles birthday. Mary volunteers to stable the new horse while Pa bathes, and is followed into the barn by Laura's dog, Jack. Unfamiliar with the new horse, Jack begins barking at it, scaring the already skittish horse, which lunges and send Mary crashing through the wall of the stable. Pa comes running, and is relieved to find Mary shaken by the experience, but relatively unhurt. That evening the family celebrates Pa's birthday.
The next day while at school, Mary collapses while playing jump rope. Laura summons Pa from the nearby mill, and Mary is taken to Doc Baker's, where Mary complains of an upset stomach. Doc Baker sends the trio off, explaining it could be nothing more than muscle spasms, and recommends a few days of bed rest. That evening, Mary wakes up with terrible pain, makes her way down from the loft, and informs Ma and Pa of her injuries. Ma confirms Mary is burning up with fever, and sends Mary back to bed while Pa sets off to fetch Doc Baker.
Morning dawns, and privately, Doc Baker informs Charles that Mary has an intestinal infection, and requires surgery that he's not capable of conducting. He recommends surgery immediately, and advises a trip to the hospital in Rochester. The trip requires a journey by train, so Charles goes into town to speak with the banker Mr. Sprague for money, while Ma stays at home to pack and arrange for Grace Edwards to take care of Laura and Carrie while Mary, Pa, and she take the train trip. Unfortunately for Charles, the bank is closed as it is Sunday morning, and Mr. Sprague is nowhere to be found. Charles overhears the church services nearby, and makes his way over. The reverend explains to Charles that Doc Baker has explained to the congregation the issues facing the Ingalls, and they have taken up a collection to offset the cost of the train and the surgery.
While dropping off Laura and Carrie at the Edwards, Grace comforts a distraught Ma, telling her she must be strong for Mary's sake. Ma, Pa, and Mary set off in their wagon towards Springfield, where they'll take the train on an eight hour ride to the hospital in Rochester.
At the hospital, Mary is examined and Doc Baker's diagnosis is confirmed: Mary will require surgery. Throughout the entire ordeal, from the time of Doc Baker's first examination, to the train ride, and finally her examination at the hospital, Mary is riddled with guilt over the worry Ma and Pa are going through, as well as the financial burden it's putting on the family. She's reluctant to tell her parents how much she's suffering, and even withholds the extent of her injury to the surgeon.
Mary is wheeled off to her room, while Ma and Pa consult with the surgeon, Dr. Mays, who explains an infection in Mary's abdomen must be drained. Surgery is scheduled for the next morning, and Pa meets with a representative of the hospital to discuss paying for the surgery. Pa is shocked at how much the medical care will cost, and promises he'll keep his weekly bills up to date.
The next morning brings surgery for Mary. Three hours later, Dr. Mays explains to Ma and Pa the infection was more severe than expected, but overall Mary's prognosis is excellent, and expects recovery will require an additional two weeks in the hospital while she's carefully observed for further bouts of infection. Charles and Caroline meet with Mary, then collapse back into their room, exhausted but relieved. The couple go into Rochester for dinner and to wire home to the Edwards, updating them on the situation. Returning to the hospital, Ma and Pa are terrified to see Mary no longer in her room. Dr. Mays informs them that Mary's temperature rose and she went into convulsions. She'll require a more invasive surgery, this time to remove the diseased tissue.
Mary has been stabilized, but is in a weakened condition, too weak for the second surgery to happen immediately. He explains it could be three to four weeks before Mary has enough strength to endure surgery. Dr. Mays knows this will cause an extreme financial burden on the family, and is sympathetic to their problem, but explains his hands are tied and he must see the hospital representative, Mr. Benson, once again to cover the bills Mary is accruing. Mr. Benson however, is not as sympathetic as Dr. Mays, but reluctantly agrees to a signed note that Charles will return home to Walnut Grove so that he can sell his farm to pay the hospital.
While at the train station for his trip home, Pa sees a help-wanted sign posted, for railroad construction work, which he takes down. Back in Walnut Grove, Charles meets Isaiah and Grace at the Post Office, and the two are devastated when they find out Mary will need more surgery. Charles explains he's back in town to speak with Mr. Sprague, but Isaiah tells him Mr. Sprague has closed the bank due to an inability to keep it going after two years of bad crops. Hard times have hit other townspeople as well, and when Charles visits Mr. Hansen at the mill, Mr. Hansen explains the mill is closed for all but one day a week, and that he's unable to buy the Ingalls farm. Dismayed he can't help Charles more, Mr. Hansen agrees to give Charles traveling money so he can look for work with the railroad. Charles agrees to meet up with Grace and Isaiah back at the Edwards farm so he can say goodbye to Laura and Carrie. Pa puts on a brave face in front of the girls, and sets out. Before he can leave, Grace and Isaiah have an announcement: Isaiah will accompany Charles, with two men working the money can be raised twice as quickly, and the two friends head out down the dusty road in search of work.
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