Plot

Doug faces possible criminal charges after Ricky Abbott dies when Ross shows Joi how to give Ricky a lethal dosage of medication. Doug is delegated to desk duty, Carol's clinic is shut down for acquiring the P.C.A. machine for Ricky, and Greene and Weaver face future disciplinary action for not reporting Doug's earlier mistakes. Meanwhile, Carter and Lucy discover a mutual attraction, Benton studies with a sign language instructor, and Romano begins his first day as acting ER chief.—Alex

The show begins with Joi begging Doug to help ease Ricky's pain. Romano storms into the ER just as Kerry is telling the staff exactly what she thinks about him ("bullet-head" is a descripter Romano takes particular interest in). Mark and Kerry wind up with all of the tasks normally done by the ER Chief (delegated by Romano). Marlee Matlin helps Benton with the task of learning sign language. Joi arrives with Ricky who is now in heart failure. Joi is requesting that no special measures be taken, but Ricky's father is demanding the boy be resucitated. When Ricky is pronounced, the father decks Doug. Romano tells Benton about an opportunity to make some fast money. Turns out that Ricky's father works for the State's Attorney and has demanded an investigation into the death of his son and has initiated murder charges against Doug. Mark finds out that the PCA machine that administered a lethal dose of medication to Ricky was obtained through the Free Clinic and that Doug provided the codes to change the dosage levels to Joi. Investigators tell Carol that Joi told Ricky's father (Joi's ex) that Doug had given Joi the codes to the PCA machine. Anspaugh informs Mark and Kerry that a full investigation into the entire matter, including Doug giving Joi pain medication that was supposed to be given only to patients participating in a double-blind study, would take place and that the Free Clinic would be closed. Lucy treats a woman hurt during a fitness workout and receives a sample kickboxing lesson from Billy Blanks himself. Just as she is stretching into a kick, Carter walks in and takes the blow in his chest. While Lucy is treating Carter, she leans in for a kiss. Carol confronts Doug about the consequences of his actions, which have affected her as well. Meanwhile, a snowstorm is starting to close down airports and roads, patients from the Free Clinic were shifted to the ER, Carter and Lucy are at it in a treatment room, and investigators are still milling around asking questions. Joi talks to Doug about Ricky's life. Despite being put on administrative duty, Doug responds to a school bus that has overturned (Mark is already on scene). With Jeanie riding along, Doug loses control of his car, slamming it into the back of a flatbed truck.