Pratt departs for Africa with attitude to spare but makes his first contact with harsh reality before the plane lands. Abby senses something is not what is seems when she treats a 12-year-old and her grandmother, then differs with Luka over the best course of action. A prisoner is brought to the ER with what everyone thinks is a fake case of appendicitis. Morris is dressed, and ready, to impress, but Albright’s not. It’s time for Kerry to return to work and Clemente doesn’t know when it’s time to leave.

Weaver cares for a Katrina survivor who's reluctant to having surgery on her foot; budget cuts force Luka to make a difficult personnel decision. Also, Gates' home life intrudes on the ER; and Pratt and Hope are shaken after a patient in their care dies needlessly.