It's Jackie's one-year anniversary of sobriety; Jackie and Frank fight, He feels he took a big unreciprocated step forward in their relationship, and now he's taking one backward; Wally, an 80 year old gay man with advanced liver cancer is admitted into the hospital. Thor instantly gravitates toward him; Zoey acts very professionally and rigid around Prentiss after their intimate evening; Carrie is notified there will be a peer review of her first few months of residency, Coop pleads for her to stay but Akalitus, Prentiss and Jackie vote against; Wally asks Jackie to administer his last rites; When Zoey learns that Grace isn't going to Jackie's anniversary celebration she rents a car and kidnaps Grace from school, Grace has a breakdown; Jackie nonchalantly takes the pill from her ring box and swallows it, she arrives at her celebration stoned in front of everyone including surprise guest O'Hara who has flown in for the special day.

Jackie and Frank have sex for the first time; Akalitus has an extra spring in her step; Coop wants to take his mentoring of Carrie to the next level; Kevin and Grace show up at the hospital after Kevin found a bag of pills in Grace's bag, Jackie delivers Grace to Akalitus and Thor who give her a scared straight tour of the emergency department; Grace has to assist Jackie with a man who collapses on the sidewalk; Jackie wants the girls to live with Kevin.

What clearly is going to be "the night" for Jackie and Frank is interrupted by Kevin, figuring she was at work. Kevin is apologetic, but Jackie is angry; Akalitus's blood results are in; Zoey helps Prentiss organize his disaster of an office; In a moment of panic, Carrie makes the right diagnosis on a patient who cannot breathe; Jackie attends an AA meeting; Jackie and Grace get into a fight after Jackie discovers Grace left campus for lunch. Jackie is convinced that Grace is sneaking behind her back to see Danny, but Grace assures her they broke up.

Akalitus forgets to hire an escort for a psych patient who then lays waste to the pharmacy; Frank cancels a lunch date with Jackie; Zoey hears Coop and Carrie having sex; Jackie worries about Frank when she learns that a cop has been shot.

Jackie and Grace recover from their nights of indiscretion; Carrie uses flashcards to strengthen her skills.

Jackie is nervous about her date with Frank, so Zoey and Thor help her get ready and Eddie offers some friendly pointers. Prentiss misdiagnoses an injured dancer, but Akalitus and Coop catch his mistake before the patient leaves. Mike Cruz calls Jackie in a moment of need.

A heavily medicated Jane Doe is brought into the ER and Jackie tasks Zoey with finding out who she is. Coop invites Carrie to dinner. Jackie faces conflict with both her daughters - Fiona has been acting out in class while Grace sneaks around the city with her older boyfriend.

After their custody meeting, Jackie rear-ends Kevin and wakes up as a patient in her own ER. Kevin accuses her of using. Coop begins covering for Carrie and taking on a lot more work. When Carrie checks on Jackie, she writes her a prescription for Oxy, unaware she's an addict. The most unlikely person asks Jackie out on a date.

Kevin demands full custody; a bus crash patient returns after contracting sepsis; Coop threatens to quit.

Victims of a bus accident are treated; two doctors join the rotation; O'Hara is happy spending time with her son; Akalitus gives Eddie his job back.