A girl, Candace Armstrong, is taking a shower, unaware of a teenage boy appearing in the room behind her. As she turns, he disappears. As she dries her hair, his hand print appears on the steamed mirror. His footprints appear on the wet tiles as he approaches her. The girl thinks she hears something but doesn't spot anyone. She tosses a towel toward a rack and it lands on the head of the invisible teen. She screams as the boy apologizes.
The guys are at a restaurant and Sam wonders why Uriel told him that Dean remembers Hell when he claims he didn't. Sam wonders why an angel would lie but Dean insists that he did. Sam isn't satisfied but drops the matter. Supernatural sightings have been sparse but Sam has a report of a ghost haunting a women's health facility shower and shoving a woman down some stairs. Dean insists on going to investigate.
The brothers arrive in town and Sam meets with Candace at a Chinese restaurant. He claims to be a writer chronicling the supernatural and asks her about the ghost. As they talk, Sam notices a guy fervently kissing a girl and vice versa. Candace explains that she accidentally fell down the stairs and wasn't pushed, and the ghost helped her up while saying not to tell his mom. He meets Dean, who has checked out the women's health facility and Candace's house without finding any EMF traces. Sam doesn't think anything is going on but notices a hunter talking to the sheriff, insisting he was attacked by Bigfoot. The brothers claim to be FBI agents and has the hunter tell them what happened. They go to investigate the site and find very large footprints. The brothers follow the footprints to a nearby grocery store where the creature stole booze and porn. They also find a tuft of hair and they wonder if the entire thing is a joke. They notice a girl riding by on a bicycle and she drops a porno magazine. They follow and see her drop off a box of alcohol and porn with a note saying "Sorry." They follow her home and find her alone. they ask her if she's seen Bigfoot and she wonders if the creature is in trouble. The girl, Audrey Elmer, says that he's her teddy bear and thinks he's sick. They claim to be teddy bear doctors and Audrey takes them upstairs to her bedroom. She opens the door and reveals a giant teddy bear that yells at her to close the door.
Audrey explains that all she ever wanted was a teddy bear but now he's ill in the head, smells, and complains a lot. She says that she wished for it at the wishing well. Dean goes in to find the teddy bear watching the news and wondering why he's there. He's depressed over the fact there's nothing else in his life except Audrey's tea parties. The guys aren't sure what to do and ask Audrey where her parents are. She says they wished to be in Bali so they're probably in Bali. They explain the teddy bear is sick and she should stay with a friend of the family, and ask where the wishing well is.
The guys go back to the Chinese restaurant as a boy makes a wish. Dean makes a wish but doesn't tell Sam. Seconds later someone arrives with a footlong sandwich for Dean. They sit down and notice the same man from earlier still kissing heavily with the girl, and figure he's a wish recipient. The brothers wonder what to do and the waiter comes over to insist they can't eat there. The brothers identify themselves as health inspectors and shut down the place due to a rat infestation. They check out the wishing well but can't find anything unusual about it. Dean wonders if Sam wants to make a wish, but Sam doesn't trust it. Sam isn't interested in wishing to go back to his old life but he admits wanting to wish for Lilith's head on a plate. Dean notices an old coin in the well but it's fastened down. They try to pry it up with a crowbar and hammer but don't have any luck. Sam takes a rubbing of the coin and has Dean check it out while he pursues a hunch.
At the women's health facility, the invisible teenager is back but Sam arrives and grabs him. The woman runs out and the boy admits he wished for invisibility. Sam tells him to put on some pants and stay visible.
Dean sees the boy from the restaurant chasing after some other boys. He sees Dean staring and snaps at him, then runs off. Dean's stomach starts to rumble and he gets to the hotel where he starts vomiting. Sam arrives and Dean explains that the wishes turn bad. He's discovered the coin is a cursed Babylonian relic with the serpent Tiamat inscribed upon it. Tiamat is the God of Chaos and its priests made the coin to spread chaos, granting wishes and turning them bad. The only way to stop it is to find the first wisher: they're the only one who can pull the coin out.
At Audrey's house, Teddy shoots himself in the head only to discover that he can't die.
Dean is dreaming of Hell when Sam wakes him up. He takes a drink and Sam says he's realized something is going on and Dean does remember his time in Hell. Sam can't come up with anything to determine who the first wisher was, but Dean spot an engagement announcement article about the couple in the restaurant, Wesley Mondale and Hope Lynn Casey.
At Wesley's house, an overly attentive Hope fixes him a snack and says she loves him more than anything. He wants her to start doing things to make her happy and she starts crying that she's making him angry. The Winchesters arrive pretending to be florists for the wedding. They notice he has a coin collection left to him by his grandfather, but Wes denies making a wish. Hope returns with her wedding plans and the Winchesters realize what wish Wes made. They get him to explain that his grandfather brought the coin back from Africa and said what it did, but said no one should ever wish on it. They're unaware that Hope is listening in the next room. When Wes refuses to go, Dean draws a gun and forces him to go to the restaurant. As they're driving, they roll over the invisible teenager. Wes is satisfied with what he has and notes that the Winchesters have it easy. They say their lives have never been easy, but Wes is happy with Hope as she is and wants to know where all the chaos is.
As they pull into town, the young boy Todd uses his newly acquired super-strength to terrorize the other boys. Dean tries to distract Todd while Sam gets Wes to the restaurant. Dean tries to get through to Todd but the boy slams him aside. At the restaurant, Wes still wonders why they can't all get what they want, but Sam says that's life. He's interrupted when a storm cloud appears and fries him with a bolt of lightning. Wes steps over him and goes into the restaurant where he finds Hope. She's made a wish and explains that she didn't want Sam to force Wes to wish away their love.
Dean goes after Todd again but the boy is invulnerable. Meanwhile, Wes tries to get through to the love-obsessed Hope. He kisses her and says he'll make everything okay, then reaches into the well and takes the coin out. Sam comes back to life and Todd releases Dean. Dean pretends to be scared of Todd and warns the bullies away from Todd, then goes to find Sam. In the restaurant, Hope doesn't remember Wes and leaves. Wes gives the coin to Sam and walks away… alone.
The town of Concrete recovers in the aftermath of the wishing gone awry. Audrey's parents have returned and her teddy bear is back to normal (except for a wound to the head). Sam melts the coin down and the brothers depart. As they go, Dean admits that Sam was right and he apologizes for lying to him. He remembers everything that happened to him but refuses to tell Sam about it. Sam says that Dean needs help but Dean says that there's nothing he can do.