Bremner and Shepherd's relationship is unravelling, and Monroe finds himself having to choose between his trainees. A woman with an aggressive brain tumor becomes of of the most challenging cases of the neurosurgeon's career.

Monroe is busy pursuing Lizzie and counseling Shepherd when an awkward, violent woman arrives at St. Matthew's with a deadly crebral aneurysm. The neurosurgeon calls on Bremner to help save her life.