"Everything's Different, Nothing's Changed" is the 151st episode of Desperate Housewives.
Paul Young stands in the way of Susan getting her much-needed kidney transplant. Meanwhile, Lynette is furious with Tom when he passes up a lucrative job opportunity in order to continue working with Carlos out of friendship, Bree becomes concerned over Andrew's escalating alcohol consumption, and Gabrielle is shocked when Renee continues as planned with her neighborhood party after the tragic suicide attempt of one of Wisteria Lane's residents.
The episode opens with Susan being called by the hospital's transplant coordinator and discovering that a kidney is waiting for her. At the same time, a doctor calls Paul and reveals that Beth has shot herself. He explains that Beth is on life support but is brain dead. Paul asks why she is being kept on life support and the doctor explains that she is an organ donor. Paul tells them not to touch Beth until he gets there and rushes to the hospital. At the hospital, Susan is surprised to see Renee, Lynette, Bree and Gabrielle waiting for her. They explain that they are thrilled to hear her good news, although Renee is put out that Susan will no longer be able to go to her party that weekend. The doctor arrives and is also surprised to see the gathering. Lynette explains that the street is happy but the doctor suggests that they must be sad as well. When the women are confused, he explains that Susan's donor is Beth and that she shot herself. The women are shocked, and Bree admits that she saw her yesterday. She criticises herself for not noticing Beth was in pain. Meanwhile, Mike asks Susan if she is alright and she admits that she doesn't know. She advises the women to go home.Later, Susan walks through the hospital and spots Paul in the waiting room. She goes over to offer her condolences and says she hopes that he will get some comfort from the fact that Beth's kidney will live on in her. However, Paul insists that he is going to keep Beth on life support and points out that Susan was never nice to Beth during her lifetime. He refuses to let Susan take the kidney. Mike is furious when he finds out and consults the hospital's lawyers. They say he would win in court but are reluctant to sue a grieving husband. However, they say they won't stand in his way. Mike vows to fight, but Susan tells him not to. She explains that it is Paul's decision to make, not theirs. That night, Mike asks Susan to explain her decision and she says it feels wrong. She points out that Beth killed herself so Susan could have her kidney but she was never nice to her. Susan adds that she can't take her kidney when she might be responsible for Beth being in hospital. Paul goes to visit Felicia, who is praying in the prison's chapel. Felicia confirms that she is planning to get Beth's life support turned off but Paul is angry about the plan. However, Felicia points out that they are responsible for Beth's death because of the "sick game" they were playing. She says Paul refused to believe Beth loved him, and she turned Beth away because she did. Paul says that if Felicia didn't believe Beth could recover, she wouldn't be praying. However, Felicia says she is praying for forgiveness and explains they should let Beth rest. Paul goes to see Susan at her apartment and explains that he has given the go-ahead for her transplant. He asks her to forget what he said, but Susan says she is confused about Beth's motives and doesn't know if she could accept. Paul asks her to honour Beth's life by allowing her to make Susan well. Susan agrees and offers her condolences again. Paul breaks down in tears and Susan hugs him.
Bree is shocked when Karen calls and reveals that Andrew broke into her house when he was drunk and passed out on her sofa. Bree goes to collect him with Andrew's husband Alex, but Andrew insists that he just had a little too much fun the night before. Bree worries that Andrew has a predisposition to alcoholism because of her but he says he is fine and falls asleep. However, Alex reveals that the situation is "really bad" and Andrew is drinking every night. He reveals that he is thinking of leaving him but Bree begs him to let her talk to Andrew first. Later, she gets Andrew to help her carry some boxes of food, claiming that she has a catering job. However, she leads him to an Alcoholics Anonymous meeting. Andrew is annoyed, but Bree says people don't have to know they are related. Andrew ends up introducing himself as 'Elvis' and refuses to share his story. Bree urges him to do so and he ends up complaining that his mother was a control freak as Bree gets increasingly uncomfortable and starts trying to butt in with her side of the story. As the group hold hands for the serenity prayer, Andrew walks out. Later, Bree goes over to Andrew's house and asks him to accompany her to another meeting. Andrew refuses and insists that he is fine. He admits that he has problems as he has no job and Alex works 18 hour shifts. He says that the only thing that keeps him going is the knowledge that he can have a few drinks in the evening. Bree accepts that and leaves, but almost immediately returns to the house. She explains that Beth killed herself because nobody cared enough to help her. She adds that she was there, knew something was wrong, and walked away, and will never do that again. Andrew starts crying and confesses that Alex left him, probably because he became a drunk. He refuses to go to a meeting because he doesn't want to talk to strangers, so Bree suggests that they have a meeting together, just the two of them. Andrew hands over his drink.
Gabrielle is shocked when she discovers that Renee is still planning to throw her party despite Beth's suicide attempt. Renee claims that life is for living and suggests that the party could be a tribute to Beth. Gaby is swayed because she bought a Versace dress for the party and Renee tells her to let the guests know the party is still on. Gaby proposes a minute's silence and champagne toast for Beth, but Renee switches it to mojitos and a toast to themselves. Gaby goes around to tell the neighbours that the party is still on but is met with disgust because of Beth's situation. However, Renee is unmoved by Gaby's suggestions that the party is in poor taste and resolves to go on with it. Gaby is shocked by her lack of compassion. The night of the party, she takes out the trash but is shocked to see several cars parked outside Renee's house. She goes to investigate and discovers that the party is in full swing. However, she soon finds out that Renee has been forced to invite people such as the pool cleaner and the man from animal control because no-one else would come. Gaby follows Renee into the kitchen asking why she decided to go ahead with the party. Renee points out that Beth brought on the situation herself, adding that only a "selfish bitch" would pass on her pain to her husband, mother and daughter. Gaby softly points out that Beth didn't have a daughter and, putting two and two together, asks Renee if her mother killed herself. Renee admits that she did but doesn't want to talk about it. She says she refuses to let her mother's suicide define her and says her party is her way of saying she chooses life over death. Gaby decides to stay for the rest of the party.
Tom is given an attractive job offer by his fellow golf player Glenn. Lynette is thrilled, especially when she hears that Glenn is offering a generous salary, stock options, and access to the company jet. However, Tom turns down the job because he doesn't want to let down Carlos. Glenn tells him that the conversation isn't over, and when he leaves, Lynette double checks that Tom wasn't playing him. Tom insists that he is turning down the offer. Later, Lynette tries to seduce Tom by pretending to be a flight attendant on a corporate jet, but again he refuses to take the offer. However, he agrees to tell Carlos to see if he can get a payrise or better benefits. The next day, Carlos hears about the offer but admits that he can't match Glenn's salary offer because the company doesn't have the cash. However, he offers Tom a new job title, a car allowance, and profit participation. Lynette is scornful when she hears about Carlos's offer and Tom asks why she keeps pushing him. She admits that if she doesn't, Tom will go nowhere. Tom is furious and says he refuses to stab Carlos in the back. Lynette says Carlos would do it if the roles were reversed because he got where he is by being ruthless. However, Tom warns Lynette that he will be ruthless if she doesn't drop the subject.
Later, Lynette goes to take an expensive sports car for a test drive and parks it on Carlos's drive. When Tom sees it, he is furious that Carlos said the company couldn't afford a payrise for Tom but he has just bought a sports car. He claims that he has half a mind to take Glenn's offer and Lynette pushes him to do it right away. Tom does so and, afterwards, decides to go and give Carlos a piece of his mind. Lynette runs after him and admits that she borrowed the car and parked it. Tom is furious that she has manipulated him and says they will take the car back and then call Glenn. They get in and Lynette points out that Tom could buy this car if he takes the job. She says he hasn't even asked himself if he wants it. Tom tells her not to talk but is impressed when he starts the car. Soon, he is enjoying himself so much that he decides to return the car to the dealer late.
The episode ends with Tom getting ready for his new job, Andrew talking to Bree, Susan preparing for her transplant and Paul saying goodbye to Beth before switching off her life support. Meanwhile, a prison warden comes to see Felicia in the chapel to offer his condolences. Felicia tearfully thanks him and the warden reveals that the parole board has decided to grant her request for humanitarian release. Felicia says that it is ironic that her daughter had to die so she could go free. The warden leaves and, when he has gone, Felicia begins to smile.
Returning after a month of absence and airing directly against the Country Music Awards, Desperate Housewives scored a new all-time ratings low with a 2.8 rating and 8.83 million viewers. With the dropping ratings, DH is no longer considered an "ABC Top 3 Show", but the episode still received overwhelming positive reviews from TV critics and fans alike.
- Kevin Rahm (Lee McDermott), Tuc Watkins (Bob Hunter), Charlie Carver (Porter Scavo), Joshua Logan Moore (Parker Scavo), Darcy Rose Byrnes (Penny Scavo) and Madison De La Garza (Juanita Solis) are absent from this episode, and are therefore not credited.
- The title of this episode comes from the lyrics in the song "Sorry-Grateful", taken from the Stephen Sondheim musical, Company.
- Alex Cominis (played by Todd Grinnell) returns in this episode - he was last seen in the season 5 episode "In a World Where the Kings are Employers". This is, however, his final appearance in the series.
- Despite Bree being a match and her willingness to donate her kidney, nothing is ever mentioned about it in this episode.
Gallery of photographic stills released to promote the episode.