Dr. Jay Sullivan is at Mercy Hospital on his second day on the job, and working to save his first patient, a gunshot wound. Jay finally manages to seal the patient's aorta and stop the bleeding, ignoring the nurse's recommendation to wait for the senior resident. Afterward, Jay tells the patient's wife that he will pull through and she hugs him relief. Paramedics bring in a suicide victim, who was hanging for what a witness reported was 20 hours. The man is alive, but has no ID. They find a journal on the suicide but the pages are empty. When Jay asks the new patient what his name is, the man says that he is Death.
After the patient is stabilized, Jay calls the psych hospital but they can't send anyone until morning. Wincing at a headache and trying to stay awake after 39 hours straight, Jay has "Death" strapped in and asks him who he is. The man insists that he is Death, and promises that he won't try to kill himself because he realizes that it won't do any good. Death explains that he's been feeling depressed since the 1300s and the Black Death, and that he can't take being a mass murderer anymore. He decides to kit and Jay wonders if anyone will die anymore. Death tells him that they won't, but figures that "they" won't let him quit. When Jay wonders how he means, Death says that they're the Celestial Choir.
Jay gets a call and promises Death that he'll be back later. As he goes, Death says that he admires the fact that the doctors at Mercy never give up. He tells Jay that he's been there before and that Billy Breem was the first soul he collected at Mercy, in 1968. Death tells Jay to look it up if he doesn't believe him.
As Jay goes to check on his next patient, the head nurse, Linda, asks how he's holding up. Jay admits that he has a headache and Linda gives him some aspirin. Jay asks her to see who the first patient to die at Mercy was and goes back to his office. He tries to sleep but Linda wakes him up to tell him that Death has disappeared. Jay goes back to the ward and discovers that the restraints are still fastened, as if his patient just slipped through them. Before Linda goes, she tells jay that the first patient to die was William Breem. Jay considers that and then considers where the real Death would go. The doctor visits the morgue and finds Death there, apologizing to the recently dead for not choosing to quit soon enough to spare them. Death figures that Jay is at least willing to consider the truth, and tosses him the journal he had earlier. There are names in it now, but Jay figures that he could have written them on his way down.
Once Death finishes apologizing to the corpses, they go upstairs and Jay finally concedes for the sake of argument that he's who he says. He wonders what it means and Death picks up a discarded newspaper and tells him to check the obituary section. When he does, Jay discovers that it's empty because no one has died. Jay insists that people die every day, but Death tells him that's no longer the case.
Back in the ward, Jay calls the newspaper and confirms that it isn't a hoax. However, he still doesn't believe that his patient is Death. The lights go out due to a power failure and Death takes on the appearance of Jay's dying mother, praying for Jay to be safe. Jay backs away, startled, and Linda comes in. Death is back to his normal non-descriptive appearance. Once the head nurse leaves, Death says that he remembers Jay from the day he came to take his mother, and that Jay must have decided to become a doctor because of the loss he suffered. Jay accepts that Death is who he says, and is happy that there will be no more death in the world. Death warns him that "they" will put on the pressure and try to force him back to work, but Jay tells him to stay strong and figures that they can deal with any problems like overpopulation caused by the absence of death.
Before they can discuss the matter further, Jay is called to the ER. A bus has crashed and the driver and passengers were badly burned. However, none of them are dying but they're all screaming in agony. Jay realizes what a lack of death really means and goes to find his patient. Death is up on the roof, dressed to leave and holding a rose. The doctor insists that he has to go back to work because people will suffer forever, and Death admits that he suspected something like that would happen.
Death asks Jay when he last stopped to smell the roses, and Jay admits that it's been a while. His new friend offers him the rose that he's holding and asks what it smells like, and Jay says that it smells like life. Death asks him if he's sure that he wants death back in the world, and Jay insists. At that, Death takes the rose and it dies. He then tells jay to look in his journal, and Jay discovers that his name is the first one in the book.
The doctor winces in sudden pain and sits down on a pain. Death touches him and the pain stops, and Jay's spirit emerges from his body. Death tells him that the headaches were symptoms of an aneurysm, and admits that he's tempted to spare Jay. However, he explains that's not how it works. As they prepare to go, Jay asks if he saved his first patient or if Death did by not being there. Death assures him that if jay hadn't been there, the patient would have been in his book. He asks Jay how it felt to save a life, something that he's never done, and Jay admits that it felt good. As they talk, they stroll off the roof to Jay's just reward.