After being shot at, Pratt, Jing-Mei and Elgin are trying to get of their sinking car. Sam took Alex with her while fleeing for Steve, Kovac is considering to go after them. Abby wants to go to bed since tomorrow is her first day as a doctor, but is thwarted by Weaver, whose custody battle might take a dramatic turn. A young drug-dealer is brought in with "a foreign object" in her tunnel of life.
Neela is still struggling with her decision not to continue becoming a doctor. We discover that Ray is in a band. Kovac and Sam are amoureux, but where does that leave them? Carter takes Abby to dinner in a restaurant he hired off for the evening.
Carter, Pratt, Kovac and Abby are dealing with a woman and her three children who've jumped from a three floor apartment trying to escape from the father. Meanwhile Dr. Lewis becomes Chief of Emergency Medicine, Howard quits his internship and Dr. Corday is facing dismissal.
From 11:22 to 12:06 we can follow everything that happens to Charlie Metcalf (played by Ray Liotta), a patient who is at death's door. We are shown the minutiae of a treatment which are usually glossed over in the "regular" episodes, interlaced with images from Charlie's delusions which give an insight into the regrets he has about his wasted life.
A wounded police officer's teenage son must make a life or death decision. Abby tries to convince a girl needing appendicitis surgery to stay at County, but her fathers wants her transferred to another hospital.
Morris is named the new chief resident, which makes nobody really happy, except Morris. Meanwhile Luka and Sam are having communication problems, Carter gets a promotion Susan really wanted and Ray finds out a 14-year old who always comes in for free drugs has been raped.
Casualties of a disaster flood the ER, which is short-handed because everyone is at Dr. Carter's going-away party because he's leaving the ER after 11 years. Dr. Pratt looks for the courage to confront his father, Charlie.