Due to his colleagues' growing concern over his behavior Josh spends the day with Stanley Keyworth, a psychotherapist from the American Trauma Victims Association (ATVA).
Josh recounts the last few weeks: His behavior began to change on the day that he was assigned to review the personal and military history of an Air Force pilot who had broken away from his fighter jet's training formation.
Days later, while discussing a political situation, Josh raised his voice to the President in the Oval Office, at which point Leo called in ATVA to talk to him.
Stanley tells him that his increasing stress and the episode at the party were triggered by the presence of a brass quintet at the White House, which subconsciously reminded Josh of police and ambulance sirens, thereby transporting him back to his own shooting and near-death in Rosslyn.
Sam is interested in a measure to tap the Strategic Petroleum Reserve to reduce high gas prices, and the staff decides to review the issue when the new year begins.