Sarah's patient Patricia Kingsley is close to dying from cancer when Sarah discovers she has a husband, Hugo. Sarah locates Hugo to convince him to be at his wife's deathbed and soon discovers why he has stayed away; Hugo is horribly disfigured (looking a lot like the Elephant Man). Roger is happily surprised when Eleanor unexpectedly reappears. She is getting sicker, though, and Tom Florin says she needs to have the tumor removed right away. To Roger's great relief, Eleanor agrees to the operation; she wants to live so she can be with him. Evan finds Patrick's behavior towards a patient, opera singer Francesca Lucchesi, inappropriate. Francesca has problems with her voice, and Patrick (who seems to have a crush on her) suggests to Evan that she may have tuberculosis like the character she is to play in the LA Opera. Evan gets her to take a test to find out, and Francesca worries. Everyone looks strangely at Hugo but he gets to be with his wife as she dies.

With Kelly and Winnie out of town, Evan drops Nick off at school a bit early. Nick's school friend Krista Lawrence is also around, and Evan also meets Nick's sexy science teacher, Donna Basher. Suddenly, without warning, someone starts shooting! There's a mad gunman loose! Back at the clinic, the others are completely unaware of what has happened. They wonder where Evan is and struggle to take care of all the patients. Sarah helps to deliver a baby for Mr. and Mrs. Simms, a black couple. However, their child turns out to be white and despite Sarah's theory that it may the result of latent genes from old family generations, Mr. Simms suspects his wife of cheating and orders a paternity test. Meanwhile, Evan, Donna and Louis, the janitor, struggle to reach the police. From his secret hiding place, the madman shoots Donna. The police arrive but can't find the shooter anywhere. They suspect he's inside the building but don't dare to enter yet.