The firefighters assist a woman thrown from her motorcycle onto a cactus patch. John, Roy, and the Rampart doctors plan a surprise birthday party for Ms. McCall; when she breaks her ankle while shopping, the party plans and the ER begin to fall apart. Dixie then tells an incompetent nurse that she will have to work the entire shift for the rest of the week when she has been ordered to get some foot therapy. Rescues include two men trapped on the side of a building with a 1/2-ton sign hanging near them; a man trapped in his new sauna after passing out, whom the doctors find to be suffering from Addison's Disease; and an old woman whose apartment building explodes during a gas leak–with John inside. John then suffers a broken foot. While recovering, Dr. Brackett brings along his first surprise for John–the recuperated Dixie, who has brought Gage a cake, while Dr. Early gives John a tape recorder, in honor of his (and DeSoto's) teacher's birthday.

A pregnant woman is accidentally shot through the abdomen, and her husband is incoherent and unable to advise how far along she is, when Dr. Brackett seriously asks him. Johnny and Roy decide to get even with Chet for his recent antics. The paramedics assist a construction worker caught under a boat at a filming location, but he refuses any IVs or needles; and a man in a motorbike accident can only move his left thumb, which he uses to help the paramedics find his son, who is in a trailer a half-mile away and in a diabetic coma, before Dixie, Dr. Early, Johnny and Roy all treat them.