Al isn’t believed and is forced to get Sam to use a leap, originally meant to help a woman pass her bar exam, for something bigger. To stop the 1960 U-2 incident from occurring and thus dramatically curtail the Cold War. Sam, who firmly states he can only impact individual lives, isn’t able to manage this anyway. However in helping the woman pass her bar exam Sam inadvertently changed history in a way he didn’t expect. Time changes and that same woman becomes the leader of the government committee that was threatening the Project, which now, under her leadership, supports it.
This means that small changes can lead to bigger changes that make everything work out in the end, right? Well, not exactly. In Season 3 episode 1 of the original Quantum Leap, “The Leap Home, Part 1,” Sam leaps into his younger self. Al explains that Sam’s mission is to simply win a basketball game which, in the long run, would improve the life of his coach and fellow players but Sam doesn’t care about that. He’s focused on the opportunity to stop his dad from dying of a coronary, his sister marrying an abusive alcoholic, and his brother, Tom (David Newsom), dying in Vietnam. Al reminds Sam this can’t be done, that in the season 2 finale of the original series they tried to change history so Al’s first wife, Beth, wouldn’t marry someone else after she presumed he was dead in Vietnam but no matter what they tried it didn’t work.
Sam presses on with his family but no matter what he does, history doesn’t change. It’s fate. Resigning himself to this, Sam wins the basketball game but ends up leaping into Vietnam in “The Leap Home, Part II.” Fate seemingly gave Sam another chance and this time he succeeded, preventing Tom’s death but at a heavy price. A photojournalist, Maggie, dies when she hadn’t in the original history before Sam leapt in. As Sam regretfully puts it, “I traded a life for a life.”
Fate can be changed, but only with sacrifice. This comes up again in the original Quantum Leap finale, “Mirror Image” where Sam is given the chance to finally go home before returning to even “tougher” leaps. While the episode is intentionally vague, one interpretation is that Sam gives up this chance to return home in exchange for changing history for Al. Sam does so and Beth and Al stay married, changing what had originally been thought to be an unalterable part of history. Sam sacrificed his chance to get home to make life better for Al, just like he sacrificed Maggie in Vietnam to keep his brother alive.
A way to change fate in a big way seems to be sacrifice, an idea that was broached earlier in the second season of the new series. In episode 4, “The Lonely Hearts Club,” government auditor Tom (Peter Gadiot, a different character from Sam’s brother in the original series) speculated, “what if sacrifice is the price we have to pay for change?”
In that episode this was in the context of “sacrifice,” being the reason a Leaper can’t get home. Still, Tom’s speculation can also apply to why bigger changes in fate can occur with sacrifice.