While drinking with friends, Bykov suddenly falls asleep. When he wakes up, he learns that he was in coma... for a long time. Events of the last couple of months were just a dream, which he had seen while spending ten years in coma (he now even has a grey beard). Very first person he meets is Gleb... who now has noticeable moustache and wears glasses. What's more shocking, Gleb is the new Head of Therapy, with his own interns (just as dumb as Bykov's ones were back in their time). Surprises don't end at this. First shocking discovery is that Kupitman became a new Chief Doctor... and completely quit drinking! But here's a problem; if Kupitman's now the Chief Doctor, who then replaced him as the Head of Venereology? Turns out that it's Lobanov, of all people. He seems to doing okay on this position, even if a bit clumsy, as everything he ever does.
Hospital under Kupitman became quite nice place — clean, beautiful and high-tech. Amongst the other people, Bykov recognises Polina and is relieved to know that she's real, and he wasn't imagining her... but now she's nurse, not intern, and visibly pregnant. Another good news is that Lyuba is finally back... older, with hairs dyed dark instead of her normal blond, and now wearing stylish glasses. She indeed visited Levin in the USA, but their attempt at reunion ended in a failure, with Levin impregnating her and abandoning due to "being not ready to become a father", and choosing science over his love. Now, Lyuba wants nothing to do with him, but at lest she's seemingly happy with her daughter. Bykov is so shocked, he needs time to digest all of this. He suddenly realises: if Kupitman is now a Chief Doctor... where's Kisegach? Kupitman reveals the truth to him. After Bykov was hit by a truck, Anastasia continued visiting him for a whole year, expecting him to get better soon. He didn't, and eventually she gave up, quit her job and married Anton. They have two children (a boy and a girl, called Constantin and Anna, respectively), and seems to be happily married. Bykov, shocked by this, refuses to listen further and asks to being leaved alone.
When visiting restroom, Bykov notices Phil... who's now a janitor, instead of a doctor, and speaks in rather strange manner. He tells Bykov his story. After he noticed Bykov's finger twitching, he rushed to inform the others, only to fall on the ladder and injure his head. He survived, but now has his mental capacities almost destroyed. He was allowed to stay as a janitor, and was even offered a place to sleep right here, in the hospital. Bykov actually feels regret for (indirectly) causing his condition. When Phil tells him that this is not his fault and that he's perfectly happy with his new life, Bykov sadly replies with "and yet another human became happier because of my coma", Phil asks him if he's so sure about his coma making anyone happier. With Phil being example obvious to everyone except for Phil himself, what he shows to Bykov instead is Gleb's marriage... with Olga, which is clearly not a happy one, and is on the verge of breaking apart.
Olga marrying Gleb means that Semyon never made peace with her. Phil can't remember why, so Bykov has to ask Semyon himself. Semyon tells Bykov his story. He was in prison for two years, and Gleb used this time to get Olga, at which he succeeded; Lobanov returned just in time to bust Gleb with Olga. Of course, this instantly and permanently ended any friendship between them. How Semyon was even imprisoned? This is most interesting... It was all Kupitman's fault. When Kupitman replaced Kisegach, he started stealing budget money, in such big amounts that it was noticed. Kupitman blackmailed Lobanov, stating that they have two options: either Semyon takes the blame, serves two years, goes free and Kupitman hires him as the new Head of Venereology... or Semyon refuses, Kupitman just straight up frames him, Semyon receives full eight yeas and Kupitman would no longer care about his subsequent fate. Having no other options, Lobanov took his offer. While Lobanov had gave up already, Bykov just feels too infuriated to let his (now clearly former) friend to get away with this, and decides to pay him a visit.
When angry Bykov enters Kupitman's office to chew him a new one, he instead meets... Kisegach, now much older, and clearly a heavy drinker. She initially mistakes him for alcohol-induced hallucination, but when she realises that he's real, she instantly faints. When awoken, she tells Bykov her story. While she's still married to Anton, she's not all that happy with her new life as a housewife; she really misses the old days, and uses the copy of the keys from Kupitman's office to visit it at nights, for nostalgia. Unfortunately, they can't just rewind everything and live a different, much happier life... Bykov doesn't want to live in this miserable world; he was much happier while in coma. The only choice he has left is to jump out from the roof, hoping what he would either survive as comatose, or wouldn't survive at all. And then... he awakes in old Kupitman's office, with not exactly sober Kupitman being present, and... in his old uniform. Was it all just a dream? It was. A nightmare. He's in Kupitman's office... not Chief Doctor's, his old one. This is morning, and Kupitman, of all people, calls him out on being too careless with alcohol.
This episode provides examples of:
- The Alcoholic: Without Bykov, Kisegach started drinking heavily and eventually became an alcoholic. When she notices Bykov in Kupitman's (formerly hers) office, she initially mistakes him for alcohol-induced hallucination.
- All Just a Dream: At first, it seemed to be that everything from this and previous seasons were just a dream Bykov had seen while in coma... but then it turns out that instead this episode was Bykov's alcohol-induced nightmare.
- Awful Wedded Life:
- After Olga divorced Semyon, she married Gleb. They are both clearly unhappy, and can't stop conflicting with each other (just most recent conflict we can witness is Olga accusing him on cheating on her with his nurses, assumption she bases solely on them being young (he, in turn, sarcastically asks whether she expected him to hire only the elder ones); him sleeping for three hours a day at best she also attributes to this. Gleb even plans to divorce her, being tired of her constant hysterics.
- Downplayed with Kisegach; she does love Anton and her children, but clearly isn't happy with being demoted to a housewife, missing old days heavily, to the point of gradually becoming an alcoholic.
- Babies Make Everything Better: Subverted with Levin and Lyuba. The moment Levin learned about Lyuba being pregnant, he abandoned her, stating that he's not ready to become a father and that "science would not forgive him this". Since then, Lyuba cut all ties with him, but still refused to get rid of the baby; she states that she's perfectly okay with rising a daughter all by herself, but if it's indeed the case and not just her hiding ugly truth from Bykov who just woke up from coma, she would be the only one from Bykov's old friends (besides Kupitman) who didn't become utterly miserable, which seems unlikely.
- Bad Future: Setting of this episode is the future caused by Bykov not awakening from his coma in the previous season, remaining comatose for ten years. Under Kupitman as the new Chief Doctor, the hospital actually received adequate budgets and became quite nice place... for the patients. Every single person Bykov used to know is now completely miserable... except for Kupitman himself, who allowed his dark side to completely overtake him.
- Bookend: Series starts with interns (Gleb, Semyon and now not presented Varya and Levin) arriving in the hospital (in slow-motion) and Bykov and Kupitman commenting them negatively. This season (but not the whole series yet) ends with three ex-interns, now doctors (Gleb, Semyon and Phil, who joined later) and Poina (who's yet to finish internship), leaving (again, in slow-motion), with Bykov and Kupitman commenting how they trained the "green newbies" into professional doctors. Just like the first time, it ends with them slipping on a wet floor, and falling.
- The Bus Came Back: Due to episode being set in Bad Future, we can see Lyuba already returning. Unfortunately, she's just as miserable as everyone else, even if she tries to hide it, due to the ugly — and likely permanent — second breakup with Levin.
- Career-Ending Injury: Phil received such crippling head trauma that he'd lost most of his mental capacities. He was offered a position of the janitor and place to live in the hospital out of pity.
- Clingy Jealous Girl: Olga accuses Gleb of "cheating" on her, basing her suspicions solely on him hiring young nurses; he predictably sarcastically asks whether him hiring only old nurses would be better. It's specifically pointed that Gleb suffers from constant stress and massive sleep deprivation, so he simply has no free energy left to chat on Olga; and he plans to divorce her to get rid of her hysterics.
- Driven to Suicide: Downplayed. Due to being dissatisfied with how real life differs from his comatose dreams (to the worse), Bykov decides that it's not worth remaining awake and jumps from the roof in hope of being put in coma again, as he was happier there. While suicide wasn't his actual goal, in his current mindset he would likely prefer death to remaining awake in this horrible world anyway. Fortunately for everyone, once he actually jumps, it turns out to be just an alcohol-induced nightmare.
- Face–Heel Turn: Not exactly saint to begin with, Kupitman completely lost the last restraints he had left once Bykov and Kisegach stopped watching over him, and became an actual villain. Remember his "minor" corruption as the Head of Venereology, like him accepting bribes and scheming to receive "his own" VIP patients? When he became a new Chief Doctor, he started stealing budget money, in such amounts that the whole "business" was busted. He framed Semyon in order to use him as a scapegoat and get away scot free, which completely ruined Lobanov's life, and, indirectly, lives of Olga and Gleb.
- Faint in Shock: When Kisegach sees Bykov (after ten years!), she faints from shock.
- Fall Guy: Kupitman blackmailed Lobanov into either taking all the blame for Kupitman's corrupt schemes, spend some time in prison and be accepted back, or be framed up, imprisoned for eight years and be left to die. This completely ruined Semyon's life and destroyed his marriage with Olga.
- Fully Automatic Clip Show:
- When Bykov falls asleep, we sees a montage of his life being "rewinded" at high speed, with some key events from various previous episodes being showed, until it stops at the moment when he fell in coma. This symbolises them not happening for real... in reality which exists only in this particular nightmare.
- Not long before Bykov finally awakes, another montage gets shown, composed of Bykov's episodes with (pregnant) Kisegach.
- Generation Xerox: According to Lyuba, her daughter from Levin looks just as her younger copy; she tries to show Bykov her photo, but he leaves before she manages to do so.
- Getting Smilies Painted on Your Soul: Phil's injury destroyed significant part of his brain and made him "happy" with such simple things as having a place to live right here in the hospital, without any need to leave (he's afraid of going outside), or old smartphone with lots of mini-games. Pre-injury Phil would clearly consider this to be Fate Worse than Death; Bykov certainly does.
- It's All My Fault: Bykov feels regret for (indirectly) causing Phil's injury (Phil injured his head when he rushed to inform everyone of Bykov's condition).
- It's a Wonderful Plot: In his alcohol-induced nightmare, Bykov "awakes" in the future where he can see how people's lives would go without him. It's not pretty.
- Jerk with a Heart of Jerk: Despite ugly circumstances of their breakup long time ago, Lyuba gave Levin another chance. It seemed that they may actually restore a broken relationship... but when he accidentally impregnated her, he refused to stay with her, justifying it as him "not being ready" and that "science would not forgive him". This is very similar to "excuse" Levin used when he decided to leave to USA in the first place, knowing full well that it would break his promise to Lyuba, but considering his "scientific interests" to be more important than their love. Lyuba wouldn't give him the third chance any time soon.
- Karma Houdini: Kupitman got away with his crimes and destroying the lives of Semyon, Olga and Gleb. He even dealt with his alcoholism. This highly contrasts with everyone besides himself being miserable.
- An Offer You Can't Refuse: Kupitman's "offer" to Lobanov; either Semyon takes the blame for Kupitman's crimes, serves time in jail and, once free, returns to work at Kupitman's old position, or Kupitman would just frame him up and let him die on the street. Lobanov chose the former.
- Stepford Smiler: Lyuba tries to show that her life as a lonely not-so-young mother is completely okay, but her happiness just seems a little bit... fake and unsettling (compared to her usual healthy cheerfulness), especially considering that nearly everyone else are utterly miserable, making her an odd exception.
- Suspiciously Similar Substitute: In Bykov's absence, his role as the Head of Therapy was taken by Gleb. Gleb throughout the episode acts very similar to Bykov, both in his role and his mannerism and relationship with his interns (who are just as dumb as old ones). To make similarity even more obvious, he now wears glasses.
- The Teetotaler: Kupitman, of all people, completely quit drinking alcohol eight years ago, even cognac; Bykov at first thinks that it's some sort of prank. Predictably, later we learn that this is not completely true, and he still drinks at times (now with Kisegach instead of Bykov), but he's indeed no longer addicted.
- Wham Line: Phil asking Bykov whether he's sure that his coma made anyone happier marks the moment when this future starts revealing its true colours. Phil being really happy is also questionable at best.
- Wham Shot: When angry Bykov enters Kupitman's office to chew him a new one, he instead meets... Kisegach, now much older, and clearly alcoholic.
