After being pushed out of his job as Chief of Staff by Kerry, Romano takes control of the ER and wreaks havoc and manages to get himself beaten up in a bar after work. Luka tries to convince Kerry to put him on the case of a Croatian child desperately in need of heart surgery, to no avail. A young woman with terminal cancer must make a choice between life-prolonging chemotherapy and the life of her unborn child. Pratt buys a birthday gift for Chen from a street vendor whose foot was run over by Elizabeth's nanny; Susan's husband (who she married the same week she met him) unexpectedly shows up from Las Vegas.

Kovac defies the rules to get a dying Croatian boy to Chicago in a race to save his life. Despite receiving tragic news, Carter tries to prevent grieving gang member Curtis from seeking vengeance. Carter's sad family gathering is interrupted by Abby's mentally troubled brother Eric, who has left his voluntary care facility. Meanwhile, Lewis has trouble ending her relationship with Chuck. Perez, a baseball player with a serious heart ailment, is treated on the eve of his pitching debut with the Chicago Cubs. And a tormented Romano makes a dramatic decision about his mangled arm, after it catches fire in his kitchen. Luka departs for the Congo after saying goodbye to Abby.