There are spoilers to be found here, so tread carefully and don't fall afoul of Frank Underwood's tactics.
This episode found Frank still hovering between life and death (that sound you hear? Satan gearing up for his arrival, but not counting on it) and Claire essentially running the country's plan to outwit the Russians and solve the oil crisis. She couldn't have more control over Vice-Acting-Whatever President Don "nervous guy in a Simpsons episode" Blythe if she was working him like a muppet.
TUSK! Ah-aaaah! Saviour of the universe! Well, just outlining the plan he's a part of that will make a deal between the Chinese, Russians and the US possible. There are worries about drilling tech (that's what the kids are calling it these days) and discussion of who should go to the G7 Summit, especially with the president's health in such a fragile state. And Bob Birch brings up the uncomfortable subject of paying for Frank's potential funeral. Appropriation? Wouldn't most of his enemies just cough up the cash if they knew it would also be a party?
We check in briefly with Frank, but he's mostly still deep in vision-world, stumbling through that forest, this time reaching a road whereupon a presidential limo sits.
Stamper is meeting with Meredith Lee (Cindy Cheung), the Secretary for Health and Human Services. He wants her to pull rank on the organ donor network to bump his boss to the top spot of the liver transplant list. Meredith refuses, clearly both great at her job (initially not giving in to illegal demands) and terrible at it (crossing Stamper is bad for anyone's health and/or human services). But he piles on the pressure, saying he'll burn through her deputies until someone agrees. She sighs and makes a call.
LeAnn's on the phone with everyone's favorite data scientist, Aidan! Well... the data scientist we have right now, at least. He's figured out that Frank's republican campaign rival Jim Conway (Joel Kinnaman, AKA sir-only-appearing-in-news-footage-thus-far) might be fiddling the search results on Pollyhop, which is a search engine and not, as you might think, one of the My Little Pony characters. LeAnn wants him to help her prove it, but he's far too smart to get involved in that. Still, he cautions, the Underwood team may have already lost the election on the digital front.
Claire is meeting with Cathy Durant, and there is a BIG disagreement on how to proceed with the G7 Summit. Cathy just wants to do her job, and Claire just wants to do Cathy's job. And Don's. And Frank's. And God's, if it's available. Cathy threatens to have Jackie Sharp get involved and Claire just inwardly snickers before scrolling through her internal rolodex of blackmail notes and calling Remy.
Talking of, he's in a car with... guess who? Jackie! They're on their way to what she hopes will be a different date. Maybe skinny dipping? But the flirty fun grinds to a halt when Remy reveals that Claire has the dirt on them. A downcast, betrayed Jackie demands to be driven home.
A still comatose Frank is suffering from something called asterixis, which means he's constantly fighting Romans in ancient Gaul... No, wait, it's something to do with an ammonia buildup in the body. From there, we re-enter his mind to take another vision quest with him. This time in a hallway that is full of people, but sounds like and then resembles (thanks to some nifty lighting effects) a train carriage. And who do we think of when trains are involved? That's right! Zoe freakin' Barnes! Kate Mara is back, ladies and gents. She beckons for Frank to follow her.
In the real world, Blythe says he won't go to the summit, just in case Frank snuffs it. But who cares what he's saying when we can dip right back into the visions and see Zoe get all scarily sexy with Frank in the Oval Office. There's straddling, and kissing, but then a sharp rap on the desk... It's Peter Russo (Corey Stoll), everyone! Frank's nightmare scenario is turning into an episode of This Is Your Life. Who will show up next? The dog he killed in the first episode? But before Frank and Zoe can get to really heavy petting, the scene switches to Peter and Zoe getting all smoochy on the couch instead. Poor Frank. Maybe try to imagine a cold shower in your vision?
Outside his hospital room, Claire meets with LeAnn, who brings up the Pollyhop issue. Both of them manage to have that word out there and maintain a straight face, which is commendable. But Claire can't focus on campaign concerns when Frank could be dead in a day.
Heather Dunbar, meanwhile, is in conference with her lawyer (Yvonne Ericson) and deciding whether to tell the truth about her meeting with Lucas Goodwin. Lying is not why she got into politics. Silly rabbit... They get into dangerous enough water that the lawyer hightails it out of the room.
Claire, looking for all the world like a Terminator on a mission, marches through the Capitol Building to find Bob Birch and Jackie meeting about the Russia plan. It seems Jackie has decided to come around and help. As Jackie walks Claire out of her office, she asks whether she's safe around Claire when she has such juicy blackmail material on her. Claire tells her she's fine as long as she works with them. Loosely translated: you're my chew toy, Jackie.
Cathy's meeting with Blythe to voice her concerns about the plan and Petrov when Claire sweeps in and convinces Blythe that she should go to the summit in Germany. Cathy, unsurprisingly, is against the idea. But with Claire in the room, she has all the authority of a night manager at a Tesco Express.
As Frank is subtly menaced by Zoe and Pete in vision-world, we cut to an unknown house, where a teenager locks himself in a room, retrieves a gun from a cabinet and unceremoniously shoots himself. We're not going to joke about this bit. It's sad and dark. But it does open the way for Frank to get a new liver.
Montage-mode returns as Seth briefs about the prez going into surgery to receive his shiny replacement organ, Claire is asked whether she wants to turn Air Force One (or maybe it's Air Force Two, since AF1 is usually only called that when the president's aboard and is anyone still reading this while managing to stay awake?) around, but insists she has to get to Brandenburg and the Summit. Plus, she really wants to try their strudel, we bet.
Claire and the gang reach the summit, and we see the early stages of meetings with the Chinese and Petrov, who asks after Frank's surgery. Subtext: "I have a bet on whether he's going to die and I don't want to lose my 20 rubles."
Heather's meeting with the DOJ officials and FBI to offer her testimony and say whether she talked to Lucas. At first, she denies it, but then turns things around and essentially launches into a campaign statement that includes how Frank has been targeting his political opponents. So much for not taking a whack at the man while he's seriously injured, eh, Heather?
More time with the machine that goes ping and in Frank's head, where a weird, head-rubbing slow-motion three-way is unfolding. As the new liver goes in, the scene changes again to just Frank and Claire sitting in the Oval. Frank's probably trying to hide a really weird erection.
Heather's testimony is being broadcast, and Stamper, watching on a hospital TV, proclaims her done. Seth, in his office, calls Cynthia and tells him he won't be helping her and the campaign any more. bu-bye!
As Stamper and Blythe wait to see whether Frank's body accepts the new liver (or if it, in turn tries to tunnel its way out of him, screaming as it goes), we cut back to the G7 summit, where Petrov is holding things up. Claire says she'll talk to him and they have a meeting where the power dynamic subtly shifts. He's all creepy smart, talking about her lips and face and she looks ready to beat his face to mush with one of the heavy books in the room.
Frank's awake! And looking pretty dreadful, but at least Peter Russo isn't rubbing his cheek on him anymore like a twisted kitty. He wants out of the hospital and he wants to talk to Claire. Who won't talk to him on the phone until she's finished verbally smacking Petrov down. She walks out triumphant, having gotten what they need.
The deal is announced on TV and soon after, we skip ahead to Claire returning to the White House, where a hospital bed is being set up in the residence. She turns in for some much needed rest on a sofa, and when she wakes up, Frank is talking with Stamper, Blythe and some of the staff from his bed in the next room. As the others leave, she asks Frank if he's in pain. Not enough for her wishes, it seems. For a man who has been shot, needed a transplant and had major surgery, Frank is surprisingly sprightly, getting out of bed and asking her to help him to the couch, where he tells her that he will back her plan. And he wants her to come back. But she says she won't be First Lady any more. "Not that", says Frank. He needs her around, and agrees things have to be different now. But still evil? Probably. We close on Frank taking back command of the country from Captain No-Spine (Blythe) and taking a quick look to camera. He's back, people. He's back.
Yes, Frank is back, in what seems to be such a fast recovery that he's practically Michael Palin's old ex-leper from Life Of Brian. But before that, it's fun to see ghosts from the past haunt Underwood, even if Kate Mara and Corey Stoll don't get much more to do than that, which is a shame. Still, the episode once again belongs to Robin Wright, whether she's sending Claire scheming through the halls or putting comrade Petrov in his place. These last couple of episodes, and indeed most of this early chunk of the season have been a true tour de force for her, and she grabs the opportunity to take the centre stage again.
Elsewhere, it's really more of a case of the plot ticking along – looks like we can say goodbye to Dunbar in preparation for the proper arrival of Joel Kinnaman's Conway. Hopefully LeAnn will continue to develop into the Stamper to Claire's Frank, and Stamper himself will get more to do than mope around at his boss's beside. More threatening people like Meredith! It's what he does best. And please, for the love of all things can we skip the "Stamper falls apart" arc this season? It's gotten tired.