Picard is in sickbay with a gaping hole in his chest. Crusher can’t save him.
In a white void, Picard meets a familiar figure, Q, who claims to be God, and conjures up a vision of Picard’s father (who is *so* disappointed), and voices from Picard’s past — people he says have died because of Picard’s actions and inactions.
We see a vision of a young Picard laughing at the sight of a spear tip emerging from his chest — the climax to a bar fight story Picard once told Wesley (s4e9 “Final Mission“).
Picard insists he regrets no part of his life, yet he’s intrigued by the chance to pluck at this loose thread from his youth. We learn that it wasn’t Picard who started the fight but his ginger sidekick Cortan Zweller. With their mutual friend Marta Batanides, they were celebrating their last few days together before shipping off to their various assignments. The young Picard had busied himself picking up women and helping Zweller plot revenge on the Naussicans, but this time he is more contemplative and respectable.
Batanides finds the change in “Johnny” appealing, so much that she asks whether Picard had ever thought about them as a couple. Picard admits he has, which leads to a fade-out and a hilarious morning-after sight gag.
When the time for the confrontation with Naussicans arrives, Picard, knowing from his experience that the Naussican is armed, shoves Zweller to keep him from throwing the first punch. That stops the fight, but it costs him his friendship with Zweller and Batanides.
We then jump to an alternate version of the present, where the Picard who has played it safe since age 21 is now slumping through an unremarkable career.
Did Q really show Picard a vision in the idiom of Scrooge and George Bailey, in order to make Picard a happier and better person? Or was this all in Picard’s head? Either way, the resolution, showing the semi-conscious Picard laughing on the operating table and then telling Riker a story about a different youthful indiscretion, assures us he is no longer ashamed of the past that made him the man he is now.