Pratt's car crashes into the river. Chen and Pratt's injuries are bad, but they're not as bad as Elgin's--he dies. Abby begins her internship at County, as do Ray Barnett and Howard Ritzke. Alex and Sam crash at a motel, where Alex places a collect call to Luka. Luka comes to find them and asks Sam to return to Chicago with him. The Lopez family gives Weaver full custody of Henry, and will take care of him while Weaver is at work. Carter and Kem scatter their son's ashes. Even Carter's proposal isn't enough to keep Kem in Chicago.

Carter hasn't been sleeping well, and falls off the wagon. Luka and Sam profess their love for each other, and Luka invites her to move in with him. Neela's parents visit, confused by her choice to drop out of Michigan. The nurses freeze out Abby after a slip of the tongue to Haleh. Weaver advises Barnett to change his appearance. Abby treats a "damage girl."

It's a busy 4th of July. Sporting a large scar on his head, Pratt is back at work, although Carter sends him home early. Neela spends the day looking for a job, although she's working in the Jumbo Mart across the street from the ER by the end of the day. Abby orders tests for one of Ray's patients. The new OR attending, Dr. Dubenko, declines to perform an illegal organ donation procedure between two HIV+ people. However, Carter convinces Corday to perform the operation. Luka takes Alex to his soccer game, although Alex isn't looking for a replacement for Steve. Susan, Chuck and baby Cosmo visit. New resident Howard may be obsessive compulsive.

A woman who threw her children out a third-floor window to escape their abusive father is discovered to have done it while going through Valium withdrawal. Susan becomes Chief of Emergency Medicine and discovers what it's like to be in management. Plagued by his OCD, Howard abruptly quits his residency, leaving a slot open. Susan can't find anybody to fill the position, but what a coincidence it is that Neela's working across the street. Corday is in trouble after her illegal organ donation procedure, facing dismissal and loss of license. Weaver offers her a non-tenured position as a clinical instructor, but Corday decides instead to quit and return to England.

A day in the life of County's interns features Pratt ordering each doctor to discharge 25 patients by the end of their shift. Ray is quickly pushing people out the door, but may be doing it by not paying enough attention to his patients. He okays a man's organs for transplant without getting sufficient consent from the man's wife. Dubenko looks out for Abby when Ray rides all over her in a trauma. Dubenko is also a little obsessed with physics. Neela proves to be a little rusty on her first day back at the hospital.

The last 44 minutes of ex-con & alcoholic Charlie Metcalf's life are in the ER, as he slowly succumbs to end-stage liver failure.

Sam and Luka are moving in together. When a raped and badly beaten woman is brought into the ER, Sam wants to try a risky procedure to let the woman talk. The woman dies, however, and Luka covers for Sam. At Susan's one-month review, Weaver suggests that she be more of a leader. Susan schedules a JCAHO drill, which proves to frustrate the staff more than help them learn. Even after she gives birth, a young girl insists that she's not pregnant.

A shot cop's 15-year-old son is given the authority to decide the course of his father's treatment, and he turns to Ray for advice. Carter accompanies Wendall rock climbing. Luka begins to take a more active role in Alex's life after he's suspended for bringing a copy of Maxim to school. An exhausted Chen returns to work, where Pratt finds her stealing potassium.

Christmas Eve finds Chen unable to locate someone to cover her shift. Because she needs to care for her dad, she quits. Pratt visits her house and tries to talk her out of euthanizing her dad, but she ends up doing it anyway. Carter and Wendall share an awkward kiss. New med student Jake and Abby treat a man with lupus and a family living in their car. Carter forces Ray to miss his plane. Morris's girlfriend visits.

While on a smoke break, Abby is kidnapped by two young gang members, who want her to fix a wounded friend. Frustrated with her subordinates not listening to her, Susan faces the fact that she can't be everyone's friend and their boss at the same time. Neela is having trouble relating to her patients.

Weaver instructs Luka and Susan to teach the residents how to work together. Susan spends the day observing the residents, some of whom can't function under her gaze. Luka and Sam argue all day but eventually make up. Abby tells Neela that she needs to find a new living arrangement. After finding out that Ray's roommate backed out on him, Neela decides to share an apartment with Ray. Following another day of Luka's guidance, Neela decides that she has a crush on him. It's Abby's first day back at work since her abduction, and it may be too soon for her to return. However, after running into med student Jake on the el (on whom she has a crush), she decides to return. Lawyer Herb Spivak returns to the ER, trolling for clients and being thrown out numerous times.

After a 16-year-old is brought in with renal failure, Carter believes that the new drug she was on was released to the public too early. The girl's neurologist, the person who recommended the drug, is a former med student of Carter's. Everyone knows about Neela's crush on Luka; he tries to pass her off to Carter for the day. After Luka tells Neela that he didn't mean to mislead her, she has a brief talk with Sam about the situation. Abby and Jake work together on a number of sex-related cases. Jake wants to date Abby, but she turns him down because she obviously can't go out with her med student.

After Pratt is dumped by a woman who says he's not a grown-up, he comes to the conclusion over the course of his day that he is. He treats a young kid with a suspicious scratch on his stomach, and lets him leave before Wendall clears him. The kid is later brought back into the ER, having been beaten to death by bullies. Susan's tenure is up for review, and since she might be fired if she doesn't bring enough money into the ER, she's trying to get multiple grants. Luka and Dubenko get into a pissing contest over a patient's treatment, and Luka turns out to be right when Pratt makes a good save. With Jake off to his surgery rotation soon, he switches the remainder of his shifts with Jane so that he can work nights with Neela and be free to date Abby. At the end of the day, after Abby has finished his evaluation, he's waiting for her on her front steps.

Weaver is spending the day working in the ER when she meets her birth mother, who has disguised herself as a patient to see Kerry. Her mom is a devout Christian, in town with her choir, and does not understand Weaver's lifestyle "choice." She offers her love, but Weaver just wants acceptance. Jake has been spending every night at Abby's apartment. Abby says it's out of convenience, but Neela thinks otherwise. Jake and Abby have trouble hiding their relationship at work, especially from Weaver. Pratt doesn't want to work with Jane. Ray gets a bedpan to the face during a fight between Carter and a Demerol junkie.

Ellie Shore is a mother of three who has a stroke and cannot speak. While she is treated, we are inside her head, hearing her thoughts. Wendall dumps Carter on their three-month anniversary, since he's clearly still attached to Kem. Neela and Ray treat three kids with a suspicious father. Morris has applied for Chief Resident. Luka and Carter want Pratt for the job, but Pratt's not interested in it. Dubenko wants to write up a case with Abby, but is he interested in taking her on a date instead? Luka and Sam discuss kids.

Gallant and Neela have been exchanging letters regularly. Gallant struggles with the war he sees every day, while Neela is searching for her life's purpose. Gallant enlists Neela's help in getting a critically burned Iraqi girl lined up for surgery in Chicago and heads for the U.S. with 72 hours leave.

Neela searches for Gallant when she discovers that he was at the hospital and didn't come see her. Eventually, he comes back and they flirt all evening and finally get it on. Gallant is in a hurry to leave when they visit the ER. Alex tells Sam that Steve is coming to town soon, and he actually shows up in the afternoon. Frank tells Luka that Steve is wanted in Colorado, and Luka barely talks him out of leaving town with Alex. Alex is not happy with Luka. Carter has invested money in a clinic that is more interested in glamour than medicine. Pratt hits on Olivia Evans, who works for an anti-violence organization called Ceasefire, and later winds up asking her for help with a shot kid.

Susan, Sam and Neela treat a woman who has tried to stop her son from being deported by going on a hunger strike. Pratt struggles to find a way to convince a woman with breast cancer to seek treatment. Abby treats two elderly sisters involved in a suspicious mugging. To Weaver's delight, Carter donates $150 million to the hospital's new venture, in exchange for naming rights. After trying to connect with an icy Wendall several times over the course of the day, Carter calls Kem and asks her opinion on The Joshua Carter Center, named after their stillborn son.

Mr. Rubadoux, whose wife was a patient of Carter's nine years ago, comes into the ER with heart problems, wanting nothing to do with Carter. Anspaugh and Kayson advise Ruby to have surgery, but Abby tries to get him to consider the alternatives. Finally, Carter tells Ruby the truth. Pratt asks Olivia from Ceasefire out. When he shows up at her office to pick him up, he's ambushed into speaking at an anti-violence meeting. Susan meets with the tenure committee. Sam is in her own world all day, and buys a pregnancy test. Ray tries to stop the Chadwick sisters from leaving without having been seen by social services. Since there's nobody better, Morris may end up with the chief resident job.

Carter receives early tenure at Susan's expense. Luka finds Sam's pregnancy test, and discovers that she's not pregnant. The two lovebirds have pretty much run out of things to talk about anyway. Pratt's friend convinces him to attend an old friend's 30th birthday party. Ray thinks a 14-year-old is a drug seeker, but he's really the victim of molestation. Abby meets Jake's extended family at his niece's baptism. Morris is the new chief resident.

Carter flies to Paris to see Kem when he learns that her mother in the hospital. Desperate to get back together with her, he offers to move back to Africa to start over again, and she doesn't really answer. Birdie and Rebecca are back; Rebecca was strangled by their niece Shelley, so Birdie stabbed Shelley. Neela, Abby and Ray all make rookie mistakes with various patients. In therapy, Sam announces that she doesn't think she and Luka should be together. Jake indirectly tries to find out where his relationship with Abby is heading.

Carter's last day at County General is marked by the "surprise" party being thrown for him. Ray takes charge when a balcony collapses at a party that he's attending. With all of the attendings at Carter's party, he talks Abby into taking 4 trauma patients while the hospital is closed to trauma. Pratt briefly visits his dad. Upset that Sam won't let him visit Steve (since he's in jail), Alex steals her credit cards and hitches a ride out of town.