Election day finally arrives with the staff eagerly anticipating the outcome; Sam is increasingly concerned about the Wilde campaign in Orange County; Toby worries about the effect of Andy's pregnancy on the voters; Donna accidentally votes for Richie and tries to rectify the situation by trying to find someone who will vote-swap; Josh resists Deborah's new office rules until she reveals their basis; Bartlet has some new health issues to worry about.

The 15-year old son of an Iranian leader needs a heart transplant in the U.S. Problem is, the only man who could do it is an enemy of the Iranian government; The Senate minority leader threatens to thwart the President's legislative agenda when he believes that Hoynes is doing some political maneuvering for the next Presidential election; Toby offers a Congresswoman a Cabinet position but is forced to take back the offer.