On Thanksgiving Day, a helicopter crash outside the ER leaves several injured, and kills Dr. Romano. Alex tries to bring Sam and Luka together.

Dr. Carter celebrates Christmas at a clinic in the Congo dealing with low supplies and anti-Americanism, but in the meantime, falling for an AIDS worker named Makemba.

Carter returns to County General to hearty welcomes. Although Abby is shocked to learn that Carter's beautiful African girlfriend, Kem, is already pregnant with Carter's child, Abby has moved on with her life as well, going back to medical school.

Dr. Carter's girlfriend makes an impression as she observes ER operations. Dr. Gallant is almost shot during a domestic incident. Dr. Weaver dedicates a center to the memory of Dr. Romano.

Sam treats an abused, pregnant teen. Dr. Carter introduces African girlfriend Makemba to wintertime. ER chaos shocks a risk-assessment expert. Dr. Pratt and Abby restrain a man who has tuberculosis.

Carter misses his pregnant girlfriend who has returned to Africa. A family of four is rushed to the emergency room after suffering carbon monoxide poisoning from their faulty furnace--forcing the claustrophobic Neela to accompany a newborn baby into an extremely uncomfortable hyperbaric chamber.

A panic-stricken Weaver is ordered to give her son to the Lopez family. Carter greets the returning Kem, but their meeting with his father, Jack, gets tense after Carter announces plans for his grandmother's estate.

Carter takes Kem to the hospital to check on their baby since it's not kicking anymore.

After being shot at, Pratt, Jing-Mei and Elgin are trying to get of their sinking car. Sam took Alex with her while fleeing for Steve, Kovac is considering to go after them. Abby wants to go to bed since tomorrow is her first day as a doctor, but is thwarted by Weaver, whose custody battle might take a dramatic turn. A young drug-dealer is brought in with "a foreign object" in her tunnel of life.

After Carter finds out Kem's mother is hospitalized in Paris he decides to go there to tell Kem how he feels about her. Meanwhile, Ray makes a fatal error.