While surgeons are operating on him, Nathan is lying in a coma and he dreams of what life would have been if Dan had chosen Karen over Deb.
In this imaginary world, Lucas is rich, snotty and popular - exactly the bad boy Nathan used to be when Lucas met him in the real world. Karen is a business woman, who is having an affair with Keith, although she is married to Dan. Unbelievable but true, in this world, Dan isn't successful: Keith owns Scott dealership and Dan works for him, even though Dan doesn't seem good at selling cars. Peyton is Lucas' girlfriend, but he does not care about her.
Deb is a single mom; she and Nathan don't have much money. Nathan and Haley are best friends, although Deb is positive they will end up getting married.

Lucas treats Nathan badly; the whole situation gets worse as soon as Lucas finds out Nathan is applying for getting into High Flyers. They decide to challenge themselves to a basketball match at the Rivercourt. Haley tells Nathan he should stand up for himself because he has to fight for his dreams.
Peyton helps Nathan out, since Lucas left him stranded because he didn't want Nathan to make it to their one-on-one match.
Thanks to Peyton's car, anyway, Nathan stops by the Rivercourt and their match can get started. Nathan wins.

Back to the normal world... Nathan wakes up! Deb apologizes to him and promises she will be a better mother in the future - yep, it turns out she wants to get over her addiction. It was about time.
Lucas shows up too. Nathan informs him about his dream and, then, Lucas admits he called Haley because "She needed to know".
As soon as Lucas walks away, Nathan calls Haley up and tells her not to come. She has to pursue her dreams, otherwise she might regret it afterwards.