A young college student in Portland, Maine arrives home early in the morning to find her parents comatose. She calls for help. A female lawyer is exiting her home and is shot unintentionally as a car drives by her home, aiming at the young out front on the sidewalk.
At the hospital, we meet Scott and Brenda, two teenage patients who both are in need of new hearts. The boy is Scott Becker, is a former alcoholic and drug addict and he has been clean 6 months. Brenda has been in and out of the hospital, waiting on a new heart for over six years.
The young lawyer, Karen is brought into the ER and Dr. Jordan attends to her. Karen is pleased to have a female doctor, feeling she will be more understanding to her needs. She has a bullet wound in her lower abdomen and needs surgery. She is concern about some of her pending cases as there is no one to cover for her. Dr. Jordan tells her that the procedure should be routine, but that there are no guarantees.
In Maine, a young girl finds out that her family was a victim to carbon monoxide poisoning and that her father did not make it. Her mother is in a coma and not expected to come out of it. The doctor tells her that her father is an organ donor and they will be making arrangements soon.
At the staff meeting, Andy introduces the staff to Scott and notes that he has been approved by UNOS for listing. Some of the members of the group are concerned and Andy states that Scott's parents are willing to help with the aftercare as long as Scott is sober. Andy goes to share the good news with Scott, only to find him in Brenda's room, in bed, kissing. Andy is not happy that Scott took out his IV for this little meeting. Andy tells him he needs to be on the straight and narrow, now that he is on the list.
Dr. Jordan runs into complications in the operation of Karen and is forced to make the choice of saving Karen's uterus. Once Karen is awake, she is informed of what happened and that her recovery time is double. She is very angry and scolds Dr. Jordan as she has no intentions or plans to have children. She tells Dr. Jordan to leave and threatens to sue her and the hospital.
Ryan and David head to Maine to get the heart for Scott. The young and David spend some time together and she explains to him the circumstances around her father's death. She also explains that she feels guilty because she out to late and if she had come home. David reassures her that her father's death is not her fault and she would have probably died had she been home.
Andy goes looking for Scott to let them know they have a heart and finds him with Brenda, just about to kiss. He shares the good news with Scott, who is concerned that it is not Brenda getting the new heart. Andy explains that it is not a matter of who has waited longer, just happens this way. Later, Pam preps Scott including putting a feed on him and then leaves for lunch.
Karen starts bleeding and Dr. Jordan rushes in to help her. Karen blames the hospital, until Dr. Jordan realizes that she got out of bed to contact her office without permission, in order to start the legal case against Dr. Jordan. Dr. Jordan saves her life and Karen is grateful.
As David is assisting in the recovery of the heart, he is in surgery he notices that something is wrong. He remembers the daughter explaining the incident and realizes that this is not simple carbon monoxide poisoning. He finds the treating doctor and together they find a possible cure for the mother. He stays while they administer the cure with his new friend. Once the mother wakes up, David and Ryan head off to the airport to take the new heart back to Three Rivers.
Andy is already in the operating room, when he is informed that Scott is nowhere to be found. The staff looks around the hospital and even talk to Brenda, all the while fearing the worse; he went back to his old ways. Pam comes back for lunch and notes that she had prepped him and they can easily locate him by GPS. When they turn it on, it shows him at the hospital; Andy realizes the only place left to look is the roof.
Andy heads up there and finds Scott, afraid of this new chance and that he will not succeed in staying off the drugs. He is also concerned that Brenda needs this heart more than he does and Andy explains that he is at a crossroad in his life and he needs to make a choice. Andy shares that he too was once at a crossroad and needed to make a tough choice. Andy tells Scott that he needs to take this heart for Brenda, so he can be there for her when it is her turn. Scott agrees to the transplant and it is successful.