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After 10 years at Chicago's County General Hospital, Attending Physician Dr. John Carter (series star NOAH WYLE) has risen to a role of respect and moral leadership in the emergency room. His recently graduated colleague Abby Lockhart (series star MAURA TIERNEY) proudly dons a doctor's white lab coat for the first time. Newly promoted to chief of staff, Dr. Kerry Weaver (series star LAURA INNES) remains as tough as ever, but chinks have appeared in her armor, especially after the loss of her life partner and the resulting bitter custody battle over their son. Attending Physician Dr. Luka Kovac (series star GORAN VISNJIC) carries on a complicated romance with streetwise, seasoned nurse Samantha Taggart (series star LINDA CARDELLINI), whose 10-year-old son, Alex (recurring guest star OLIVER DAVIS), looks up to Kovac as a role model, friend and, sometimes, substitute father.

Lonely, Carter struggles with his unfulfilled dreams in the wake of his girlfriend's departure--and lurches towards a dangerous temporary solution. New doctor Abby deals with resentful nurses and tends to a tearful, injured young woman kidnapped from Mexico and forced into sexual slavery. Meanwhile, Kovac makes a confession to a fleeing Sam. Neela's domineering, old-fashioned Indian parents arrive and are upset that she abandoned her Michigan medical assignment. Later, Carter treats an Iraqi war veteran who was disfigured in combat; Weaver suggests to new intern Ray (new series star SHANE WEST) that he tone down his alternative-punk look in deference to frightened patients; and two staffers recover from their injuries.

On a busy Fourth of July weekend, Carter oversees an understaffed hospital that is flooded with patients. An HIV-positive biker remains brain dead as the result of a robbery, and his girlfriend wants to donate one of his organs to his friend, who is also infected with HIV. After several surgeons refuse, Carter persuades Corday to perform the organ transplant. Meanwhile, Ray is upset with Abby because she bypassed his orders and requested a drug test on his patient, a bicycle messenger. Abby later asks Carter to dinner in hopes of talking to him about his past problems. Pratt performs below his normal capabilities when he returns to work too early after having a craniotomy--a type of brain surgery in which the doctor removes part of the bone from the skull to get to the brain.

Two small children are rushed to the emergency room after falling out of a third-floor window. The medical staff believes an abusive father is responsible for the tragedy, but the truth is later revealed. While treating a man who complains of an unsightly rash, Pratt diagnoses the real problem--the patient has lung cancer. Corday is disciplined by hospital administrators for ignoring Proper protocol when she performed an organ transplant on an HIV-positive patient. Instead of being terminated, Corday is offered a position that will not lead to tenure. Sam contemplates moving in with Kovac. Neela decides to leave her job at the mini-mart after Lewis, newly promoted to chief of emergency medicine, offers her a position at the hospital.

Neela starts a new job in the emergency room after working at the convenience store near the hospital. On Neela's first day, Pratt expects the interns, Abby, Ray and Neela, to take on a large patient load during their shifts. Pratt turns processing the patients into a competition, in which Ray is clearly going to be the winner. In his rush to remain in the lead, however, Ray makes a big mistake and donates a patient's organs against the family's wishes. Ray helps Abby obtain HIV medication from the pharmacy--against hospital policy--for a patient who had unprotected sex. And Carter pursues Wendall (recurring guest star MÄDCHEN AMICK - "Twin Peaks," "Gilmore Girls"), who works in child protective services.

This groundbreaking episode traces real-time events in the emergency room as Kovac, Abby and Sam struggle to save the life of Charlie Metcalf (RAY LIOTTA - "GoodFellas," "Field of Dreams"), a man who complains of stomach pain but is later diagnosed with a life-threatening condition.

Sam and Kovac treat a woman who was brutally beaten and raped and wants to help the police--although she can barely speak. Lewis schedules a surprise JCAHO (Joint Commission on Accreditation of Healthcare Organizations) emergency drill. Carter and Abby tend to a girl complaining of kidney problems, but that's just the beginning of her adventure.

When a police officer shot during a robbery is rushed to the emergency room, Lewis, Neela and Ray stabilize him, but the injuries to his carotid artery, which supplies blood to the brain, leave him in a coma. The stricken officer's 15-year-old son must decide whether to authorize a risky operation that may save his father's life or to leave him permanently comatose. Abby tries to convince a girl with appendicitis to have surgery at County General, but her father wants her transferred to another hospital because his father died during an operation at County.

On Christmas Eve, the emergency room staff scrambles to finish work and go home for the holiday. While Abby treats a dialysis patient who is in critical condition, she can't reach his personal physician because he doesn't want to be disturbed during the holidays. Meanwhile, after much effort, a distraught Chen finally finds someone to work her shift so she can take care of her ailing father. Concerned for her, Pratt stops by her house and finds her struggling with her father's worsening health. Carter and Wendall (recurring guest star MÄDCHEN AMICK) grow closer and share an awkward kiss as they wish each other a merry Christmas.

Recently promoted to Chief of Emergency Medicine, Lewis finds out how hard it is to be in charge of her colleagues. Patient satisfaction scores are down from the previous years, and it's primarily because the residents are not spending enough time listening to the patients--especially Neela, which surprises Kovac. When Lewis confronts Abby about instances when Abby has circumvented accepted procedure to help patients, Abby angrily goes outside for a break. An SUV zooms in and a frantic boy, Little C (KENDRE BERRY), begs her to look at his wounded older brother, CJ (EDWIN MORROW). But when Abby bends to look into the car, she is pushed in and abducted by the gang members, with no witnesses.

In an effort to raise plummeting patient satisfaction scores, Lewis directs Kovac to teach the residents effective patient communication. Two teenagers are brought to the emergency room with gunshot wounds. Kovac, Neela and Sam treat one victim while Lewis, Pratt and Ray attend to another. When one of the patients dies, Neela does a poor job of informing the grandmother--who becomes hysterical. A personal injury attorney sets up a mobile office outside the emergency room, infuriating Lewis as the lawyer attempts to turn dissatisfied patients into clients. Abby returns to the ER even though she is still experiencing the trauma of her recent abduction.

When a 16-year-old girl who had received a kidney transplant from her father arrives at the emergency room feeling dizzy, Carter traces the problem to a new drug that the girl was taking to control seizures related to her kidney dysfunction. Her father feels guilty because he pushed for her to take the new drug, and its side effects may force his daughter to go back on dialysis. The doctor who prescribed the medication, Dr. George Henry (CHAD LOWE - "Life Goes On"), is Carter's former student. Carter asks Neela to post information about the drug's side effects on the Internet, which causes an uproar when the pharmaceutical company finds out. After Abby and Neela complain about their lackluster dating lives, they are assigned to work with Jake (recurring guest star EION BAILEY - "Almost Famous," "Band of Brothers") and Kovac--men they each find attractive.

While examining a young boy, Pratt finds a suspicious gash across his chest and calls Wendall (recurring guest star MÄDCHEN AMICK) for a consult. Kovac and Pratt examine a man who was shot when he confronted his boss with a gun. Jake (recurring guest star EION BAILEY) tries to convince Abby to date him despite his being a student.

Weaver encounters an evasive patient, Helen Kingsley (FRANCES FISHER - "Titanic," "House of Sand and Fog"), who shocks her by revealing that she is her birth mother, who at the age of 15 delivered Weaver and put her up for adoption. As they share life stories, their budding relationship withers when Weaver confesses to the evangelical Christian that she's a lesbian. Meanwhile, Pratt warily assigns Jane (recurring guest star SARA GILBERT - "Roseanne") to attend to a confused elderly woman, while Carter causes a commotion when he confronts a scheming couple hoping to get some painkilling drugs.

When Ellie Shore (CYNTHIA NIXON - "Sex and the City"), a young mother of three, is brought in with symptoms of a potentially fatal stroke, Kovac and Sam fight the odds to save her life. Knowing that a controversial surgical procedure is his wife's only chance at a full recovery, Ellie's husband must make the unenviable decision to risk her life in order to save it. Meanwhile, Neela and Ray discover a dark secret when three ostensibly neglected children show up in the emergency room. And Carter is in the midst of a love triangle when Wendall's (recurring guest star MÄDCHEN AMICK) professions of love force him to either cut ties to his ex-girlfriend in Africa or lose Wendall.

In Iraq, a young girl is wounded in a car bombing, and local hospitals are not equipped to help. Michael Gallant (former series star SHARIF ATKINS), who is stationed in Iraq, enlists Neela's support to secure the necessary treatment at County General, but getting the girl to the United States proves to be extremely difficult. With time running out, Gallant resorts to calling in a favor to bring the young girl to Chicago. Meanwhile, Neela is redefining her role at the hospital and rediscovering her romantic feelings for Gallant.

Neela is surprised when she hears that Gallant (former series star SHARIF ATKINS) came to the emergency room with a young Iraqi burn victim. Sam is troubled by a visit from her ex-husband. Pratt treats a child whose gun discharged, and the doctor learns that the boy received the weapon from an unusual source.

The staff treats a woman suffering from the effects of a hunger strike, but the patient refuses to accept food or help until she has proof that the INS (U.S. Immigration and Naturalization Service) will grant her son's deportation case a new hearing. Neela, Sam and Lewis are unable to treat her as long as she and her lawyer refuse aid--which goes against all of their training. Meanwhile, Abby suspects that a 72-year-old woman, Birdy Chaddock (Academy Award winner LOUISE FLETCHER - "One Flew Over the Cuckoo's Nest," "Star Trek: Deep Space Nine"), is a victim of elder abuse but is unable to prove it.

Eighty-five-year-old Jules "Ruby" Rubadoux (recurring guest star Academy Award winner RED BUTTONS - "Sayonara," "The Poseidon Adventure") is wheeled into the emergency room and erroneously accuses Carter of killing Ruby's wife 10 years ago. Although Abby believes Ruby is too old to undergo surgery to correct a heart murmur, the attending doctors opt to perform the operation. Meanwhile, Pratt treats a domestic violence victim and makes a date with the social worker assigned to the case. As Pratt arrives for the date, he realizes he has gotten himself into more than he bargained for. Former series star PAUL McCRANE directed the episode.

Much to everyone's chagrin, Dr. Archie Morris (recurring guest star SCOTT GRIMES - "Band of Brothers") is appointed as the new chief resident and immediately challenges Pratt as they treat casualties from an apartment building fire. Frustrated at not achieving tenure, Lewis is short-tempered with Carter. Weaver tries to pacify Lewis but only makes things worse. Ray heeds the advice of several doctors at the hospital and discharges a teenaged sickle-cell anemia patient.

Pratt loudly reprimands Neela for performing a complicated procedure on a baby; Abby misdiagnoses a patient; and Ray's procedural misstep on a victim who was stabbed produces terrible results. Meanwhile, Carter travels to Paris after learning that Kem's (recurring guest star THANDIE NEWTON - "Mission: Impossible 2") mother has been hospitalized. Once there, Carter makes some life-altering decisions.

On Carter's final shift at County General, four new interns begin their medical careers. After completing their rounds, Carter, Kovac and most of the emergency room staff attend Carter's surprise going-away party. Ray leaves to go to another event where the revelry is interrupted by a disaster that truly tests his triage abilities. The casualties are taken immediately to the hospital where a skeleton staff, headed by Abby and Neela, must overcome their lack of experience and treat the patients. Meanwhile, Pratt finally gets the courage to confront his father, Charlie (recurring guest star DANNY GLOVER - "Lethal Weapon" films, "The Royal Tenenbaums"). And Sam and Kovac search for Sam's son after he runs away in search of his imprisoned father.