Jackie talks to Akalitus, concerned that Dr. O'Hara (Eve Best) will tattle on her about her pill problem. Jackie makes it seem like it isn't really a problem, but a misunderstanding. O'Hara does come in to speak with Akalitus, immediately following Jackie's meeting, but dances around the issue, rather than ratting Jackie out. Akalitus is stone faced for much of both meetings, but you can see the gears turning in her head. She is taking it all in, and she will act when necessary. She values her employees, but also has the hospital to worry about. Adding comedy to what otherwise would have been a tense scene, the phone keeps ringing, and Akalitus gets increasingly frustrated with it, rather than with the women in her office. Smith handles it all brilliantly, both the broad and the subtle equally, with massive talent.
At the beginning of the episode, Jackie tries to explain away the pharmacy charges to her husband, Kevin (Dominic Fumusa). He doesn't buy her excuses, which ring hollow when the secret post office box Jackie gets her credit card bills in is taken into account, and storms off in anger. Is there any hope of rebuilding trust in their marriage? I don't know. I assume they will be staying together, at least for the time being, but I can't see them having easy fun ahead. She fundamentally betrayed him, on a deep level. There is nothing she can say to make things right, because what she has done is so wrong.
Kevin seems concerned about something besides the pills, too. He knows Jackie doesn't think he makes enough money, as she is willing to accept funds from O'Hara for their children's tuition, and that hurts his pride. So he has the school fees put on various credit cards, and still can only manage a half payment. Kevin's pride is a huge obstacle that will also need to be overcome for the couple to reconnect. He needs to accept that he can't do everything alone, and that sometimes it is all right to accept help. While his flaws are not as serious as Jackie's he does have them.