The ER staffers are in decidedly unfestive moods as Christmas arrives. Carol's spirits are lifted by a Santa-like patient. Mark is outraged when Jenn decides to stay in Milwaukee over Christmas. Benton and Carter score points with Vucelich when Carter convinces an older gentleman, Ruby, to include his wife in Vucelich's study. Mark gives a deposition in the O'Brien case. The death of a priest threatens to start a gang war. Weaver receives a surprise visit from an African friend. A Holocaust survivor, the victim of a carjacking, brings Chanukah to the ER.

Shep and Raul bring a dozen malnourished and abandoned children into the ER, keeping everyone very busy. Shep has a run-in with Malik and Benton when he makes an off-handed racially insensitive remark. Carter's high from the admission of Mrs. Rubadoux to the study ends when she shows no signs of recovery. Jeanie and Carol clash when Jeanie receives a poor evaluation. Al asks Jeanie to give him another chance. Mark is served with divorce papers.

Mark tries to find a way to tell Rachel about his impending divorce. Benton attends a banquet at Vucelich's home, with Jeanie as his date. Carter finally tells Mr. Rubadoux about his wife's terminal condition, making the man furious. Morganstern is admitted to the hospital after breaking a leg at a Scottish family reunion.

Benton decides to blow the whistle on Vucelich's unethical study methods, causing Vucelich to drop him from the study. Susan treats a street couple, one of whom has passed HIV to the other. Doug receives a visit from his estranged father. Carter spreads rumors about an affair between Mark and Susan. Mark buys a motorcycle. Prostitute Loretta has cervical cancer.

Jules 'Ruby' Rubadoux is back in the ER. He's still angry with Carter about the death of his wife.