When a 16-year-old girl who had received a kidney transplant from her father arrives at the emergency room feeling dizzy, Carter traces the problem to a new drug that the girl was taking to control seizures related to her kidney dysfunction.
While examining a young boy, Pratt finds a suspicious gash across his chest and calls Wendall for a consult. Kovac and Pratt examine a man who was shot when he confronted his boss with a gun. Jake tries to convince Abby to date him despite his being a student.
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.
Much to Ray's dislike, a surrogate mother in labor doesn't want to have a C-section and endangers the life of the baby. Meanwhile, Sam tells Luka she and Alex are moving out. Pratt meets his half-brother and -sister, and Abby makes a difficult decision about a young boy.
The rainy night brings in diverse patients including a mother involved in a car accident with her baby, a man with a satisfaction facilitator, and a comatose patient who suddenly wakes up. Also, Sam steps up to Eve and her strict ways and Jerry gets struck by lightening!
A new attending, Dr. Victor Clemente, comes aboard and quickly makes a stir on the ER. Abby's breast cancer patient convinces her to take a long awaited test. Luka befriends a young woman who awakes from a six-year coma. Also, Weaver shows Clemente who runs the ER.
Pratt's half-brother tries to get him to make ends meet with his estranged father. Clemente treats an infant chimpanzee and involves Abby and Neela on the secret case. Eve promotes Sam and her first tasks is to fire a beloved nurse.
Gallant impulsively asks Neela to marry her that exact day, she says I do but soon gets cold feet. Morris stands up to Weaver on a patients course of treatment. Luka, Sam and Clemente treat a boy who contracted HIV from his mother. Also, Abby and Luka redefine their relationship and Luka is named the new Chief of Emergency Medicine.
Pratt and Weaver try to create a Christmas miracle when they work to save a girl wounded from gunfire. Eve gets into trouble after punching a disruptive patient. Also, Abby has a special gift for Luka.