In this episode of ER, the following happens. We open this last ever episode of ER on a Monday morning at 4:00am. And of course we are straight away thrown into the ER drama. Then comes the thing I have been hoping/praying for, the ER credits are back!
We also soon learn that it is Sam's birthday. Then we see Susan and Kerry being shown around the Joshua Carter Centre by Carter himself. Possible new interns are shown round the ER by Pratt's brother, Chaz, and we see that one of them is Rachel, the late (and great) Mark Greene's daughter. A pregnant woman is brought into the ER. She has been in a car accident and is in labour, she is having twins. Soon one of her baby's, a girl, is delivered in the ER and it isn't long before the next one is on its way. Rachel introduces herself to Frank and as soon as she mentions who she is, he starts to look upset, almost as if he is about to start crying. Soon the 2nd baby is born, another girl, but she isn't doing as well as her sister. Then the mother starts getting worse and everything turns into a game of touch and go. They manage to stabilise the mother and soon she and the twins are taken to the OB wing of the hospital. As everyone is moved, the husband/father just stands in the room, and starts at all of his wife's blood on the floor. Soon word gets round about Rachel being in the hospital, and so Carter goes to see her. When they met, we learn that she is now 22 and that Elizabeth is in Chicago with her. So carter invites them to the opening of the Centre. She goes in for her interview and we see that Banfield is doing the interviews. We also see that Alex and Gates are working on a car for Sam. As the Carter Centre opens, we see that everyone is there, and then Kem shows up. Carter also tells the story of why the Centre is named the Joshua Carter Centre. Carter sees that Kem is there and he makes his way through the crowds to go and speak to her. When an intern goes to check on the twin's mother, we learn that she died. Alex turns up at the ER and takes his mother outside and gives her his surprise present, a red Mustang. At first is worried where Alex got the car from (possibly believing that he has stolen it), but she soon learn the truth from gates and is beyond happy with her present. Elizabeth and Rachel don't make it to the opening but they join the old gang for drinks. Soon they all disband, but Carter, Susan and Rachel all head into the ER. As a patient dies, we see Gates and Sam reuniting. We see Carter and Gates playing basketball, just like in the good old days. The hospital soon gets a call that there has been an industrial explosion nearby and that the casualties are only a few minutes out. And so it is all hands on deck. Everyone is outside as they waiting for the ambulances to start arriving. As ambulances start rolling in, there isn't enough room for them all and so they end up in the street, with ambulances. As the cameras move out, we see the County as a whole, and the famous music starts playing. Then the tears start rolling down my face, this is the last ever ER. And what a great ending to an amazing show.