This season premiere picks up well after last season's season finale entitled "Kisangani," an episode named after the tribal village in the Congo where the episode was set in. Where "Kisangani" leaves off with Carter and Luka in Africa working with Doctors Without Borders, "Now What?" picks up with Carter's less-than-joyful return to Chicago. Upon his arrival in Abby's apartment, she asks for her key back and kicks him out promptly without any regards to his feelings. In fact, Abby is extremely self-centered this episode when it comes to her relationship with Carter: she seems to only care about how she'll feel if he leaves for Africa to do the noble deed of bringing Luka's body home after receiving a phone call that tells the staff of County General that he had died.
This episode also features the arrival of med student Neela Rasgotra (a name that prompts Frank to insensitively say "Don't hey hire Americans around here anymore?"). She faces a tough first day when Pratt begins to flirt with her (much to the dismay of Jing-Mei Chen). This seems to cause Chen to harshly come down upon Neela for reasons that the student couldn't seem to comprehend.
We also have various other mini storylines that don't seem to be of much importance to this episode's plot. The ER is undergoing rennovations which means that there's plenty of opportunity for humor through downed phone lines, flickering computers, and falling panes of glass.
Overall, this episode was a good way to kick off the tenth season of ER.