Hannah and her awful cousin Rebecca duke it out. Credit: HBO Hannah's grandma is dying from pneumonia. Her mom asks her to come see her grandmother, so Hannah packs her bags and goes to the hospital and gives Grandma Flo a kiss. Hannah and her mom walk out to grab a bite and chat. Hannah's mom tells her Grandma Flo was never a good mother, but then asks Hannah to tell Grandma that she's marrying Adam just to make her happy before she dies. Hannah visits her cousin Rebecca, who's a nervous, uptight wreck. No one on the show has ever been less likable, and that's quite a feat: Rebecca manages to take everything as an insult and insults everyone and everything at the same time.
Hannah's mom and her sisters are starting to talk about what possessions will go to whom and they start arguing about Grandma Flo's engagement ring. Hannah calls Adam and tells him that she has to lie to Grandma Flo and they have an awkward conversation about marriage and Hannah gets upset, even though she didn't want to marry Adam in the first place.
Hannah and Rebecca go to a bar, where Rebecca tells Hannah she doesn't drink. Hannah tells Rebecca she's rude to her and Rebecca blames this on the fact that Hannah told her her dad went to prison for insider trading. Rebecca then reveals, oddly enough, that she is in an open relationship with a guy who has another girlfriend - Rebecca's rather Amish-like outfit doesn't exactly scream polyamorous. (Or maybe it does? Sister wives, anyone?) She claims it's good for her because she's so busy. Then Rebecca goes off on an ex-boyfriend who was a writer and starts talking about how terrible writers, presumably including Hannah, are. They get into an argument and insult each other and in the car Rebecca claims that Hannah had the idea for the two of them to touch their "chachis" together when they were little kids. Rebecca texts while she's driving and the two of them get into a car accident.
The two of them go to the hospital and Adam magically shows up after borrowing Desi's motorcycle, then yells at Hannah for texting him "emergency." Hannah's mother and aunts come to the hospital and get into such a huge blowout fight that a nurse threatens to kick them out. Hannah's hippie aunt bawls, "Our mother is naked and dying upstairs. Naked and dying!" Hannah holds Rebecca's hand. She takes Adam into Grandma Flo's room and Grandma Flo tells Hannah she's not up to meeting new people. Then, Adam tells her he and Hannah are getting married. Grandma Flo tells Hannah that one day she will wish Adam will die the most violent death possible - and that moment will pass.
Hannah jokes that if Grandma lives then she'll have to marry Adam. Hannah's mom then says she hopes Hannah won't marry him because "it's not easy being married to an odd man" and the two of them get into an argument. The next morning, Grandma Flo is suddenly all better. She has an appetite and she's happy and healthy. Hannah takes the train back to Grand Central. She gets a phone call from Rebecca: Grandma Flo just died.