Dr. Tony Gates treats a teenage girl in a coma with alcohol poisoning after she played drinking games with her friends. Gates calls the police when he discovers that the parents of the girl's friend supplied the alcohol, and has the friend's father arrested. Later, the girl's parents arrive, and request she be transferred to Mercy Hospital. Before she can be transferred, the girl finally awakens, but just thrashes around, and is sent for a new CT to diagnose possible brain damage.
Dr. Julia Wise new to County General, treats a homosexual HIV-positive patient who has severe breathing difficulties. It is discovered he has terminal cancer. With the support of his partner, he decides not to seek treatment, as he has already outlived most of his friends who died at the height of the AIDS epidemic in the 1980s.
An elderly patient named Beverly is brought in by a fire engine with a broken wrist, and comments on Dr. Archie Morris' "soft and strong" hands. She is later claimed by her daughter, as she had wandered off before her accident. She returns later, having wandered off again but otherwise not further injured.
A married couple comes in with the woman going into labor with twins, and John Carter and Simon Brenner handle the delivery. During the delivery of the second baby, complications set in. It turns out she has an inverted uterus, and requires an emergency caesarean section. The second baby comes out requiring intensive care, and the mother ultimately dies in surgery trying to fix the complications.
Mark Greene's daughter Rachel is visiting the hospital as a prospective medical student, and is interviewing for a spot in the teaching program. She is interviewed primarily by Catherine Banfield who confides to Carter afterward that she made it through the first cut. Carter shows her around after her interview, giving her a few pointers she will need if/when she is accepted into a medical school.
Carter opens his clinic for the underprivileged, with Peter Benton and his son Reese Kerry Weaver and Susan Lewis among the guests. He named the facility after his lost son, Joshua. After the event, he has an awkward reunion with Kem who is briefly in town. He also has drinks with his old friends plus Elizabeth Corday who brought Rachel to Chicago for her med school interview. Benton and Corday linger together after everyone else go their separate ways.
Marjorie Manning a previous elderly multiple sclerosis patient, comes in with her husband suffering sepsis and pulmonary edema. Mr. Manning is initially unwilling to let Marjorie go, but with guidance from Dr. Gates, he finally accepts the inevitable. Before Marjorie dies, her daughter arrives, and confides in Samantha Taggart her regrets over her relationship with her mother. This leads Samantha to call her own mother.
It turns out it is Samantha's birthday. Her son Alex reveals her present: a vintage Ford Mustang restored by Alex and Tony, who both decided upon bright red as its color over cobalt blue.
A young woman and her new mother-in-law both come in, in separate ambulances, with minor injuries sustained in a drunken brawl at their wedding reception, and continue arguing all the way into the treatment rooms. The groom later arrives, and is promptly torn between tending to his mother and his new bride.
The episode ends with the beginning of a disaster protocol: an industrial explosion, with a minimum of eight casualties. Dr. Carter is again pressed into service to assist. Dr. Morris is ordered by Dr. Banfield to triage patients as they arrive. The first patient was thrown 20 feet, and is diagnosed as a possible lacerated spleen or liver, to be sent straight to the OR. The second patient has a compound leg fracture with no circulatory impairment, which Dr. Banfield takes herself for an orthopedic consult. The third patient was electrocuted, and flatlined on the way in, declared DOA. The fourth patient has smoke inhalation, relatively minor burns and a pneumothroax, and is set up for a chest tube. The fifth patient had his left arm blown off below the elbow, with nothing left to save; Dr. Gates takes him in to repair the damage. Dr. Morris gives the sixth patient to Dr. Carter: third-degree burns over 90% coverage. As he runs the patient in, Dr. Carter asks Rachel to tag along, which she does enthusiastically. As Morris continues to triage patients, the original theme song plays and the scene pans out, revealing the entire hospital for the first time.