A severe blizzard leaves the ER utterly devoid of patients, and the staff takes the opportunity to goof off. Doug and Linda return from the Caribbean just as Carol makes a surprise announcement. The fun and games are quickly abandoned when a call comes from dispatch about a 32-vehicle pile-up with mass casualties. The ER goes from deserted to capacity, and all surgeons are called in. Bob surprises everyone when she makes a quick, life-saving decision, and a new ER attending, Dr. Angela Hicks, arrives.

Carter fumbles his first opportunity to observe a surgery. Susan's nemesis, Dr. Kayson, makes her New Year's Day decidedly unpleasant. Chloe announces she's moving to Texas with her boyfriend. Peter and his sister try to sort out care for their ailing mother.