Carlos and Gabrielle decide to adopt, but the process comes to be a lot more difficult than either had expected. Susan finally has her surgery as she finally has medical insurance. Meanwhile, a showdown between Bree and her son Andrew lead to a full out war between mother and son. Also, a dying Noah Taylor learns more about Paul Young and his biological grandson Zach. Lastly, Tom is having more difficulty at the job when having to take orders from his boss and wife Lynette.