Susan institutes extra precautions in case Chloe tries to reclaim Little Susie. Mark changes his look, growing a goatee and wearing contact lenses. Carol and Jeanie square off over the care of a transient. Carter celebrates when he receives his residency match, putting his patient and his job at risk. Shep, still suffering from Raul's death, is surly with new parter Reilly. Benton and Ross have differences when Peter discloses a critical mistake made by Doug, raising animosity between the two.

Carter engages in competition with new surgical resident-in-training Dale Edson upon learning that residents will be evaluated and graded; only the top ones advancing to second year. It doesn't help that Dale once had a relationship with Harper. Mark flirts with infomercial director Iris. Peter faces the fallout from his altercation with Doug when surgeons begin dropping him from procedures. Shep begins exhibiting uncontrolled hostility, first to a patient being abusive with Carol, then a pedestrian. Susan and Chloe try to reach an agreement regarding Little Susie.

Susan visits a psychiatrist to cope with the loss of Little Susie. Jeanie's estranged husband Al checks in the ER complaining of flu-like symptoms, which turn out to be caused by HIV. Shep expects Carol to back his version of events during an official investigation of his behavior. Loretta takes a turn for the worse. Doug discovers that his father has disappeared with a LOT of Karen's money.