Peter and Cleo may be at fault when a police officer shoots and kills an old woman with dementia. Carter misinforms Rena and tells her that he and Abby had a past liaison. April Fool's Day causes the staffers to play pranks on each other; Malucci gets the worst of it when Kovac injects him with Haldol, rendering him useless for the rest of the shift and getting his hand glued to his forehead while asleep. Corday endures a particularly long surgery just to prove that she can despite her pregnancy. Greene treats three young students who have been huffing carpet cleaner. Luka treats another pregnant teenager, who wants the comfort that a child will bring her.

Corday goes into labor and delivers a baby girl named Ella. Benton treats his junior high school science teacher. Numerous college students come into the ER, victims of fraternity/sorority pledging pranks and hazing rituals. Carter and Abby take a road trip to Oklahoma to pick up Maggie, who has locked herself in a motel room; then she steals sleeping pills from a convenience store and attempts suicide. Rena dumps Carter over the phone.